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

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

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.

In plain terms: 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.

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.

Evidence grade: A

Sources: Qu C et al. (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. <https://doi.org/10.1371/journal.pmed.1001774>; Cui F et al. (2017). Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases. <https://doi.org/10.3201/eid2305.161477>

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.