Infantile hepatitis B in immunized children: Risk for fulminant hepatitis and long-term outcomes

Yu Ru Tseng, Jia Feng Wu, Man Shan Kong, Fu Chang Hu, Yao Jong Yang, Chun Yan Yeung, Fu Chen Huang, I. Fei Huang, Yen Hsuan Ni, Hong Yuan Hsu, Mei Hwei Chang, Huey Ling Chen

研究成果: Article同行評審

16 引文 斯高帕斯(Scopus)

摘要

Background: Infantile hepatitis B after neonatal immunoprophylaxis is a rare yet distinct disease. This study aimed to analyze the long-term outcomes and risk factors in immunized infants with hepatitis B.

Methods: The clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBVpositive hepatitis were studied. All patients were followed for at least 6 months (median = 4.4 years, range 0.6-18.1 years). Patient survival, changes of HBsAg and HBeAg status, and complications were analyzed.

Results: Among the 41 cases (32 males, 9 females), 21 presented with fulminant hepatitis (FH), and 20 with non-fulminant hepatitis (NFH). Ninety-five percent (36/38) of the mothers were positive for hepatitis B surface antigen (HBsAg). Multivariate analyses revealed younger age of onset (age <7 months) and negative maternal hepatitis B e antigen (HBeAg) were associated with FH (p = 0.03 and p = 0.01, respectively). An infantile fulminant hepatitis B risk score using maternal/infant HBeAg positivity and onset age was proposed. Among the FH cases, the rate of mortality, HBsAg clearance, and chronic HBV infection were 47.6%, 38.1%, and 14.3%, respectively. Among the NFH cases, 35% developed chronic infection. Of the 9 chronically infected children received long-term follow-up, 8 had HBeAg seroconversion before 4 years of age. One case of FH developed hepatocellular carcinoma 14 years later.

Conclusions: Maternal HBsAg +/HBeAg- and early onset age were risk factors for FH in immunized infants. A significant portion of patients with FH or NFH evolve to chronic HBV infection, with HBeAg seroconversion in young childhood. Close surveillance for hepatocellular carcinoma is warranted in patients surviving infantile hepatitis B.

原文English
文章編號e111825
期刊PloS one
9
發行號11
DOIs
出版狀態Published - 2014 十一月 7

All Science Journal Classification (ASJC) codes

  • 多學科

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