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  Vol. 22, No. 3  Previous Table of Contents Home  Next February 15, 2000 

Dr. Beasley Wins International Honor for Hepatitis B Work


by SCOTT MERVILLE
The University of Texas-Houston Health Science Center

Dr. R. Palmer Beasley, dean of The University of Texas-Houston Health Science Center School of Public Health, will receive another prestigious international award for his relentless and successful pursuit of a solution to the deadly puzzle posed by the hepatitis B virus.

Photograph
Dr. R. Palmer Beasley receives the 1999 Prince Mahidol Award for Medicine from Her Royal Highness Queen Sirikit of Thailand.

King Bhumibol Adulyadej and Queen Sirikit of Thailand presented Dr. Beasley with the Prince Mahidol Award for Medicine on Jan. 31 at the Grand Palace in Bangkok.

The annual prize, awarded by the Prince Mahidol Foundation on the recommendation of an international panel of experts, is a tremendous honor for Dr. Beasley, says Dr. M. David Low, president of UT-Houston. "Few, if any, medical professionals in the world have done more to prevent cancer than Palmer Beasley," Dr. Low says. "The Prince Mahidol Award is well-deserved recognition for 30 years of outstanding work, which includes proving that the hepatitis B virus is the major cause of liver cancer, a controversial idea at the time. His subsequent leadership in establishing the vaccine and advocating global inoculation has saved countless lives worldwide."

In addition to his connecting of hepatitis B to liver cancer (hepatocellular carcinoma), the award citation also notes Dr. Beasley's groundbreaking work on transmission of the virus, including the discovery that infected mothers pass the virus to infants during childbirth.

Dr. Beasley says receiving the Prince Mahidol Award is thrilling and gratifying. "I have had the rare good fortune to see through a complete problem, from establishing the epidemiology of transmission and the connection to liver cancer, to conducting definitive studies on immunization, to leading the effort for worldwide immunization."

Dr. Beasley, who remains involved in hepatitis B research and prevention advocacy, stressed that "many people contributed to the work for which I am being honored, including my own team of more than 20 people in Taiwan, scientists and public officials in Taiwan, many people in numerous countries, and my wife and co-investigator Dr. Lu-yu Hwang."

While the worldwide hepatitis B epidemic remains severe, particularly in Asia and Sub-Saharan Africa, immunization has a successful track record. Dr. Beasley and his colleagues conducted the original, definitive field trials of hepatitis B virus vaccine in Taiwan, providing the data essential for licensure of the vaccine, which is now used in about 100 countries. Today, Taiwan has an excellent immunization program, Dr. Beasley says, "and it has been dramatically successful." Hepatitis B carrier rates among Taiwanese have dropped from the 12 to 15 percent range to 1 percent. The World Health Organization notes that hepatitis B vaccine is the only vaccine against a major human cancer.

Hepatitis B is transmitted by infected mothers during childbirth, through unprotected sex, the sharing of unsterile needles and via close contact with chronic carriers (child-to-child, mother-to-child), including persistent exposure to saliva of chronic carriers.

Two Prince Mahidol awards are made annually, one for public health and one for medicine. A $50,000 cash prize for each is included. There were 57 nominees from 25 nations this year for the honor named after Thai Prince Mahidol of Songkla, the father of King Bhumibol. Prince Mahidol personally financed the training of a core group of scholars in the basic sciences and worked continually to upgrade medical care in Thailand. He earned his M.D. and a certificate of public health from Harvard, and returned to Thailand to practice medicine. He died at age 37 in 1929.

Dr. Beasley came to UT-Houston to lead the School of Public Health in 1987. The school now ranks third nationally in funded research and has grown in enrollment, programs, faculty and prestige. Dr. Beasley earned his undergraduate degree at Dartmouth College and his M.D. at Harvard. He holds a master's degree in preventive medicine from the University of Washington. He also is professor of epidemiology and the Ashbel Smith Professor at the School of Public Health.

Dr. Beasley's work on hepatitis B earned him the King Faisal International Prize in Medicine in 1985 and the Charles S. Mott-General Motors Foundation Prize in 1987.

Beasley Battles Hepatitis B

"As a young resident in infectious diseases and international health, I was almost feeling like I had missed out. All the great infectious diseases - small pox, polio, measles - had been conquered," says Dr. R. Palmer Beasley, dean of The University of Texas-Houston Health Science Center School of Public Health. "Hepatitis B looked like the most important unsolved infectious disease."

When Dr. Beasley began his research in 1969, hepatitis B was a lethal mystery that struck particularly hard in East Asia, most notably in South China and Taiwan. Today, the World Health Organization reports that more than 2 billion people have been infected with the disease, 350 million remain chronic carriers and more than 1 million people a year die from cirrhosis of the liver or liver cancer caused by hepatitis B, mainly in Sub-Saharan Africa and Asia.

Once a marker for hepatitis B was discovered in human blood, Dr. Beasley leaped at the chance to attack the virus. Working out of the U.S. Naval Research Unit No. 2 in Taipei (he lived in Taiwan as a member of the University of Washington Medical School faculty from 1972 to 1986), Dr. Beasley and colleagues embarked on a series of studies that discovered:

  • Hepatitis B causes liver cancer. In a study of 23,000 government employees which began in 1976 and continues today, Dr. Beasley demonstrated this relationship and showed that 20 percent of Taiwanese men die of hepatitis B-induced liver disease, either cancer or cirrhosis or both.
  • Transmission from mother to infant during childbirth is the principal force sustaining hepatitis B worldwide, causing 40 percent of cases.
  • Immunizing at-risk newborns within hours of birth prevents 95 percent of these perinatal infections, a remarkable finding that early vaccination can eliminate an infection that already has been introduced.
  • Presence of HBeAg, a small protein near the virus core, predicts which mothers will infect their infants with greater than 95 percent accuracy. Commercial tests based on these findings are used worldwide to determine which infants need swift immunization.
  • Hepatitis B can be transmitted by persistent exposure to a carrier's saliva. (Children play a significant role in infecting other children, and saliva exposure, such as sharing a toothbrush, is one way this occurs.)
  • Children, once infected, are more likely than adults to remain chronic carriers of the virus.

Dr. Beasley subsequently persuaded the World Health Organization to adopt the hepatitis B vaccine into its global immunization program, drafting the original strategy and presenting it to the World Health Assembly. The assembly made the vaccine the seventh global vaccine. More than 500 million doses have been administered since 1982.

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