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Public health policy for management of hepatitis B virus infection: historical review of recommendations for immunization.

Chronic hepatitis B virus (HBV) infection is the leading cause of cirrhosis, liver failure, and liver cancer, and an estimated 620,000 persons die annually from HBV-related liver disease (Goldstein et al., 2005; World Health Organization, 2000). Immunization with the HBV vaccine is the most effective means of preventing HBV infection and its consequent acute and chronic liver diseases such as cirrhosis and hepatocellular carcinoma. The HBV vaccine has been used against HBV in the United States since 1982 (Centers for Disease Control and Prevention, 1982); during the last 25 years, HBV vaccine policy continued to evolve in response to public health issues and epidemiologic data. Although the number of newly acquired HBV infections has substantially declined as a result of implementation of a national immunization program, the prevalence of chronic HBV infection remains high. The purpose of this article is to review the epidemiology of HBV, provide a historical review of health policies for HBV immunization, and summarize the recent evidence-based public health guidelines for management of HBV infection in the United States.