The impact of national viral hepatitis therapy program and hepatitis B vaccination program on mortality from acute and chronic viral hepatitis in Taiwan

  • Shih-Yung SuEmail author
Original Article



In Taiwan, the national hepatitis B virus vaccination program and national viral hepatitis therapy program were implemented to control the infections of hepatitis viruses and their progressive illnesses. Studies have evaluated the impacts of two national health programs on many liver-related diseases, but not on acute and chronic viral hepatitis. The purpose of this study was to evaluate the impact on the mortality of acute and chronic viral hepatitis.


Poisson regression models were used to estimate the adjusted rate ratios of the different period groups and corresponding 95% confidence intervals for childhood, adulthood and elderhood, and to estimate the adjusted rate ratios of vaccinated cohorts and corresponding 95% confidence intervals.


Compared with period of 2000–2003, the adjusted rate ratios for period groups of 2008–2011 and 2012–2015 reported a significantly increasing risk of acute and chronic viral hepatitis mortality, except for the childhood and female adulthood. For population without vaccination, the adjusted rate ratios of acute and chronic viral hepatitis B mortality were 0.99 (95% CIs 0.88–1.12), 1.30 (95% CIs 1.17–1.45) and 1.42 (95% CIs 1.28–1.55) for periods of 2004–2007, 2008–2011 and 2012–2015, respectively, comparing with unimplemented period of national viral hepatitis therapy program. Compared with 1967–1983 cohorts, the adjusted rate ratio of 1984–2000 cohorts was 0.46 (95% CIs 0.28–0.75), and the adjusted rate ratios were 0.49 (95% CIs 0.28–0.87) and 0.35 (95% CIs 0.11–1.05) for male and female, respectively.


This study revealed the significantly higher mortality rates of acute and chronic viral hepatitis during the implemented period of national viral hepatitis therapy program, comparing the unimplemented period. Such ineffectiveness may be attributable to the low coverage rate. The national vaccination program was currently an effective strategy for controlling the mortality of viral hepatitis.


Mortality Acute and chronic viral hepatitis Hepatitis B vaccination 



Hepatitis B virus


Hepatitis C virus


International classification of disease


Confidence intervals


Direct-acting antiviral agents


Aristolochic acids and their derivatives


World Health Organization



This manuscript was edited by Wallace Academic Editing. I would like to thank the Editors of the journal and all reviewers for their comments.



Compliance with ethical standards

Conflict of interest

No reported conflicts.

Supplementary material

12072_2019_9931_MOESM1_ESM.docx (43 kb)
Supplementary material 1 (DOCX 42 kb)


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Copyright information

© Asian Pacific Association for the Study of the Liver 2019

Authors and Affiliations

  1. 1.Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan

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