|Title:||Pediatric Fulminant Hepatic Failure in Endemic Areas of Hepatitis B Infection: 15 Years after Universal Hepatitis B Vaccination||Authors:||CHEN, HUEY-LING
LEE, I- HSIEN
|Issue Date:||2004||Journal Volume:||v.39||Journal Issue:||n.1||Start page/Pages:||58-63||Source:||HEPATOLOGY||Abstract:||
To investigate the role of hepatitis B virus (HBV) infection in pediatric fulminant hepatic failure (FHF) after the launch of universal HBV vaccination, the authors analyzed the data from patients with FHF collected from a nationwide collaborative study group. Children aged 1 month to 15 years who were diagnosed with FHF (62 males and 33 females) between 1985-1999 were included. HBV infection (hepatitis B surface antigen [HBsAg] and/or immunoglobulin M hepatitis B core antibody [IgM anti-HBc] seropositive) accounted for 46% (43 of 95 cases) of all the cases of FHF. The average annual incidence of FHF in the time period 1985- 1999 was 0. 053/ 100,000 in the group of patients ages 1-15 years and 1. 29/ 100,000 in those patients age < 1 year. Approximately 61%(58 of 95 cases) of all FHF cases were infants. The percentage of HBV infection was found to be higher in infants (57%) compared with children ages 1-15 years (27%) ( P = 0.004). The incidence rate ratio of those patients age < 1 year to those ages 1-15 years was 54.2 for HBV-positive FHF and 15.2 for HBV-negative FHF. Maternal HBsAg was found to be positive in 97% of the infants with HBV-positive FHF, and hepatitis B e antigen (HBeAg) was found to be negative in 84 % of these infants. Approximately 74% of all HBV- positive FHF patients and 81% of the infantile HBV-positive patients had been vaccinated. In conclusion, within the first 15 years of universal vaccination, HBV was found to rarely cause FHF in children age >1 year but remained a significant cause of FHF in infants. HBV-positive FHF was prone to develop in infants born to HBeAg-negative, HBsAg- carrier mothers ; these infants had not received hepatitis B immunoglobulin according to the vaccination program in place
|Appears in Collections:||醫學系|
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