The Impact of Hepatitis on Clinical Outcomes for Pediatric Patients with Aplastic Anemia
Journal
Journal of Pediatrics
Journal Volume
227
Pages
87-9300
Date Issued
2020
Author(s)
Wang W.-H.
Lin D.-T.
Lin K.-H.
Abstract
Objectives: To assess the prognostic role of hepatitis in pediatric patients with aplastic anemia and the incidence of hepatitis B among patients with hepatitis-associated aplastic anemia in an area with a previously high prevalence of hepatitis B after nationwide hepatitis B vaccination for 30 years. Study design: Pediatric patients (n = 78) with aplastic anemia were enrolled in this study, including 9 with hepatitis-associated aplastic anemia. We collected the clinical characteristics, etiologies of the aplastic anemia, hepatitis B virus serology and serum hepatitis B viral load, response to the treatments, and survival outcome from the participants. We applied univariate and multivariate Cox regression analysis to evaluate the correlations between clinical features and survival outcome. Survival analysis was done using Cox regression model and Kaplan-Meier curves. Results: Patients with hepatitis-associated aplastic anemia were related to significantly worse survival prognosis when compared with patients with non-hepatitis-associated aplastic anemia, and hepatitis-associated aplastic anemia was the only independent prognostic factor to predict a poor survival outcome in our patients with aplastic anemia by multivariable analysis. In none of the total 78 patients was aplastic anemia related to hepatitis B virus infection. Conclusions: Patients with hepatitis-associated aplastic anemia had a significantly worse prognosis when compared with patients whose aplastic anemia was not hepatitis-associated. This study demonstrates the potential benefit of hepatitis B vaccination in decreasing the incidence of hepatitis-associated aplastic anemia in children. ? 2020 Elsevier Inc.
SDGs
Other Subjects
antibiotic agent; cyclosporine; thymocyte antibody; immunosuppressive agent; adolescent; aplastic anemia; Article; child; clinical feature; clinical outcome; controlled study; female; hepatitis B; human; immunosuppressive treatment; major clinical study; male; pediatric patient; priority journal; prognosis; survival; treatment response; virus load; aplastic anemia; blood; case control study; complication; hepatitis B; Hepatitis B virus; infant; isolation and purification; Kaplan Meier method; mortality; newborn; preschool child; proportional hazards model; severity of illness index; Taiwan; virology; Adolescent; Anemia, Aplastic; Case-Control Studies; Child; Child, Preschool; Hepatitis B; Hepatitis B virus; Humans; Immunosuppressive Agents; Infant; Infant, Newborn; Kaplan-Meier Estimate; Proportional Hazards Models; Severity of Illness Index; Taiwan
Publisher
Mosby Inc.
Type
journal article