14

Get tested for hepatitis B markers; if no antibodies, get vaccinated

UpdatedGrade ABig benefitLifespanLow costLittle timeNo willpower

The test itself is very inexpensive. In Qidong’s 30‑year follow‑up study, infants who received the hepatitis B vaccine at birth had an 84% lower risk of developing primary liver cancer and a 72% lower rate of carrying the hepatitis B virus compared to unvaccinated peers. Adults found to have no antibodies should receive three vaccine doses over six months at a cost of roughly 100–300 yuan.

Cost
The test costs just a few dozen yuan per person. For adults lacking antibodies, three doses of the hepatitis B vaccine cost between 100 and 300 yuan total, to be completed within six months.
Benefit
This Qidong trial used group randomization rather than individual assignment and was tracked for three decades. Vaccination at birth cut primary liver cancer incidence by 84% (95% CI 23%–97%). The prevalence of hepatitis B surface antigen (HBsAg) fell by 72% (95% CI 68%–75%), reflecting a comparable drop in the proportion of people carrying the virus. Nationwide in China, HBsAg prevalence dropped 52% between 1992 and 2014, and fell 97% among children under five.
Notes
This recommendation applies to adults born before 1992 who never received the vaccine or whose antibodies have waned. The 84% cancer‑risk reduction pertains only to those immunized at birth; adolescents vaccinated later saw only a 21% reduction in virus carriage. For adults, the main goal is preventing new infection, not achieving the same cancer‑prevention benefit. Vaccination offers no protection to people already infected; they must see a hepatologist regularly. Infection is confirmed when the hepatitis B surface antigen (HBsAg) test result is positive.
Sources · 2
  1. Qu C 等 (2014). Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study. PLoS Medicine. doi.org/10.1371/journal.pmed.1001774
  2. Cui F 等 (2017). Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases. doi.org/10.3201/eid2305.161477

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