An enormous hepatitis B virus-related liver disease burden projected in Vietnam by 2025

Background: Hepatitis B virus (HBV) is the major cause of chronic liver disease in Vietnam. This study aimed to estimate and project chronic HBV prevalence and HBV-related liver cirrhosis (LC) and hepatocellular carcinoma (HCC) for the period 1990-2025. Method: The Vietnamese population for the period 1990-1999 was derived from census data to 1999 and from 2000 to 2025 based on projection data from the United States Census Bureau. Population chronic HBV prevalence for males and females was estimated based on age-specific HBV prevalence from Vietnamese community-based studies. Universal infant HBV vaccination from 2003 was assumed to reduce HBV infection by 90% in subsequent birth cohorts. Incidences of HBV-related LC and HCC by HBV DNA levels from the Taiwanese REVEAL studies were applied to the chronic HBV population to estimate and project HBV-related liver disease burden. Results: Estimated chronic HBV prevalence increased from 6.4 million cases in 1990 to around 8.4 million cases in 2005 and was projected to decrease to 8.0 million by 2025. Estimated HBV-related LC and HCC incidence increased linearly from 21 900 and 9400 in 1990 to 58 650 and 25 000 in 2025. Estimated HBV-related mortality increased from 12 600 in 1990 to 40 000 in 2025. Conclusion: Over the next two decades, universal infant HBV vaccination will reduce chronic HBV prevalence in Vietnam but HBV-related liver disease burden will continue to rise. A national HBV strategy is required to address this expanding burden of liver disease.