Surveillance for Transmission of Hepatitis B in Child Day Care

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1002-1004
Author(s):  
Hjordis M. Foy ◽  
Paul D. Swenson ◽  
M. Jayne Freitag-Koontz ◽  
Janice Boase ◽  
Tianji-Yu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Day Care ◽  
Case Reports ◽  
Hepatitis B Surface Antigen ◽  
Horizontal Transmission ◽  
Acute Infection ◽  
Venous Blood ◽  
Core Antigen ◽  
Day Care Centers ◽  
Blood Specimens

Relatively little is known about the risk of transmission of hepatitis B virus (HBV) in day-care centers; the virus is primarily spread by blood and other body secretions. Gradual horizontal transmission of hepatitis B has been observed in homes for the mentally retarded.1-3 Horizontal spread in children appears to be of equal importance with vertical transmission in countries where hepatitis B is endemic.4 These infections, which usually are asymptomatic, may result in chronic carriage and may go undetected unless children are tested for hepatitis B markers. Studies in day-care centers in Okinawa, where HBV carriage is relatively common, suggest that transmission may occur in day-care centers.5 Case reports of HBV transmission in school or day-care settings in the US6 and Italy7 have been published. Our study was undertaken to determine whether there is evidence of horizontal transmission of HBV infections in US day-care facilities. To evaluate this, we screened for the antibody to hepatitis B core antigen (anti-HBc), a marker which is seen both in those who have recovered from hepatitis B and those who are carriers.8 Capillary blood specimens, obtained by finger prick, were used. Children who tested positive had venous blood specimens drawn and their families were approached for consent to draw venous specimens also from the household members to evaluate if the infection may have originated in the family. The venous specimens were tested also for additional markers, especially for hepatitis B surface antigen (HBsAg), which is found during acute infection and in carriers, and antibody to HBsAg (anti-HBs) which develops after infection and immunization.

scholarly journals History of posttransfusion hepatitis

1997 ◽  
Vol 43 (8) ◽  
pp. 1487-1493 ◽  
Author(s):  
Leslie H Tobler ◽  
Michael P Busch
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Hepatitis Virus ◽  
Hepatitis B Surface Antigen ◽  
Substantial Reduction ◽  
Surrogate Marker ◽  
Core Antigen ◽  
Viral Agent ◽  
Posttransfusion Hepatitis

Abstract The risk of hepatitis virus transmission from transfusions has declined dramatically from that of the 1940s when posttransfusion hepatitis (PTH) was first appreciated. Introduction of hepatitis B surface antigen screening and conversion to volunteer donors for whole-blood donations in the late 1960s and early 1970s led to substantial reduction in PTH cases. However, up to 10% of the recipients continued to develop PTH, most cases of which were attributed to an unknown non-A, non-B viral agent. Implementation of surrogate marker testing (i.e., alanine aminotransferase and anti-hepatitis B virus core antigen) for residual non-A, non-B hepatitis in the late 1980s reduced the per unit risk of PTH from 1 in 200 to about 1 in 400. Hepatitis C virus was discovered in 1989 and quickly was established as the causative agent of >90% of non-A, non-B PTH. Introduction of progressively improved antibody assays in the early 1990s reduced the risk of PTH due to hepatitis C virus to about 1 in 100 000. Although additional hepatitis viruses exist (e.g., hepatitis G virus), these appear to be minor contributors to clinical PTH, which has been virtually eradicated.

Hepatitis B Virus Reactivation in Lymphoma Patients With Prior Resolved Hepatitis B Undergoing Anticancer Therapy With or Without Rituximab

2009 ◽  
Vol 27 (4) ◽  
pp. 605-611 ◽  
Author(s):  
Winnie Yeo ◽  
Tung C. Chan ◽  
Nancy W.Y. Leung ◽  
Wai Y. Lam ◽  
Frankie K.F. Mo ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
B Cell Lymphoma ◽  
Anticancer Therapy ◽  
Hbv Dna ◽  
Core Antigen ◽  
Hbv Reactivation ◽  
B Virus

Purpose Reactivation of hepatitis B virus (HBV) infection is a well-recognized complication in cancer patients with chronic HBV (hepatitis B surface antigen [HBsAg] positive) undergoing cytotoxic chemotherapy. In patients who have resolved HBV (HBsAg negative and antibody to hepatitis B core antigen [anti-HBc] ± antibody to hepatitis B surface antigen [anti-HBs] positive), such incidence has been much less common until recent use of rituximab. In this study on HBsAg-negative/anti-HBc–positive lymphoma patients, the objectives were to determine the HBV reactivation rate in patients treated with rituximab-containing chemotherapy and to compare it with the rate in patients treated without rituximab. Patients and Methods Between January 2003 and December 2006, all patients diagnosed with CD20+ diffuse large B-cell lymphoma (DLBCL) had HBsAg determined before anticancer therapy. They were treated with either cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) alone or rituximab plus CHOP (R-CHOP). HBsAg-negative patients had anti-HBc determined; serum was stored for anti-HBs and HBV DNA. All patients were observed for HBV reactivation, which was defined as detectable HBV DNA with ALT elevation during and for 6 months after anticancer therapy. Results Among 104 CD20+ DLBCL patients, 80 were HBsAg negative. Of the latter, 46 patients (44.2%) were HBsAg negative/anti-HBc positive; 25 of these patients were treated with CHOP, and none had HBV reactivation. In contrast, among the 21 patients treated with R-CHOP, five developed HBV reactivation, including one patient who died of hepatic failure (P = .0148). Exploratory analysis identified male sex, absence of anti-HBs, and use of rituximab to be predictive of HBV reactivation. Conclusion Among HBsAg-negative/anti-HBc–positive DLBCL patients treated with R-CHOP, 25% developed HBV reactivation. Close monitoring until at least 6 months after anticancer therapy is required, with an alternative approach of prophylactic antiviral therapy to prevent this potentially fatal condition.

Hepatitis B prevalence in the Turkish population of Arnhem: implications for national screening policy?

2011 ◽  
Vol 140 (4) ◽  
pp. 724-730 ◽  
Author(s):  
C. RICHTER ◽  
G. TER BEEST ◽  
I. SANCAK ◽  
R. AYDINLY ◽  
K. BULBUL ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
The Netherlands ◽  
Hepatitis B Surface Antigen ◽  
Turkish Population ◽  
Target Population ◽  
Core Antigen ◽  
Hospital Records ◽  
Screening Policy ◽  
The Individual

SUMMARYDespite the increased prevalence of hepatitis B and C in most migrant groups in The Netherlands, a national screening policy for these infections is not available. In order to estimate the prevalence of hepatitis B and C in the largest group of first-generation migrants (FGM) in The Netherlands, we conducted a screening project in the Turkish community of Arnhem. In a separate project we identified patients from the target population with chronic hepatitis B and C from hospital records (1990–2008). Educational meetings concerning hepatitis were organized, with all participants being offered a blood screening test. Participants were tested for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc) and antibodies to hepatitis C virus (anti-HCV). In total 709 persons were tested, a complete dataset was available for 647 patients. We found that 3·0% and 0·4% of Turkish FGM aged >24 years in Arnhem had active hepatitis B, defined as HBsAg positive, and tested positive for anti-HCV, respectively. The hospital records revealed another 32 patients, 28 with hepatitis B and four with hepatitis C representing 0·7% for hepatitis B and 0·1% for hepatitis C in relation to the total number of Turkish FGM in Arnhem. We believe that active hepatitis screening of FGM from Turkey should be part of the national health policy as it will benefit the individual and public health.

scholarly journals Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization

2001 ◽  
Vol 126 (2) ◽  
pp. 285-289 ◽  
Author(s):  
M. M. NABULSI ◽  
G. F. ARAJ ◽  
I. NUWAYHID ◽  
M. RAMADAN ◽  
M. ARISS
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Horizontal Transmission ◽  
Cross Sectional Study ◽  
Family Characteristics ◽  
Hepatitis B Infection ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
South Lebanon ◽  
Infection Markers

This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6·5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0·8 % with increasing age-specific rates from 0 % at 6 months to 1·3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2·9 %) and South Lebanon (1·6 %). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitis B vaccine during the first year of life is needed.

scholarly journals Low Risk of Hepatitis B Virus Reactivation in HBsAg-negative/Anti-HBc–positive Carriers Receiving Rituximab for Rheumatoid Arthritis: A Retrospective Multicenter Italian Study

2016 ◽  
Vol 43 (5) ◽  
pp. 869-874 ◽  
Author(s):  
Valentina Varisco ◽  
Mauro Viganò ◽  
Alberto Batticciotto ◽  
Pietro Lampertico ◽  
Antonio Marchesoni ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Core Antigen ◽  
Hbv Reactivation ◽  
Serum Hbsag ◽  
B Virus

Objective.Patients with resolved hepatitis B virus (HBV) infection, i.e., hepatitis B surface antigen (HBsAg)-negative/antihepatitis B core antigen (anti-HBc)-positive, undergoing rituximab (RTX)-based chemotherapy for hematological malignancies without anti-HBV prophylaxis are at risk of HBV reactivation, but the risk in such patients receiving RTX for rheumatological disorders is not clear. We evaluated this risk in HBsAg-negative/anti-HBc–positive patients with rheumatoid arthritis (RA) undergoing RTX without prophylaxis.Methods.Thirty-three HBsAg-negative/anti-HBc–positive outpatients with RA with undetectable HBV DNA by sensitive PCR assay [73% women, median age 60 years, 85% with HBsAg antibodies (anti-HBs), 37% with antihepatitis B envelope antigen] received a median of 3 cycles of RTX (range 1–8) over 34 months (range 0–80) combined with disease-modifying antirheumatic drugs (DMARD) without prophylaxis. All underwent clinical and laboratory monitoring during and after RTX administration, including serum HBsAg and HBV DNA measurements every 6 months or whenever clinically indicated.Results.None of the patients seroreverted to HBsAg during RTX treatment, but 6/28 (21%) showed a > 50% decrease in protective anti-HBs levels, including 2 who became anti-HBs–negative. One patient (3%) who became HBV DNA-positive (44 IU/ml) after 6 months of RTX treatment was effectively rescued with lamivudine before any hepatitis flare occurred. Among the 14 patients monitored for 18 months (range 0–70) after RTX discontinuation, no HBV reactivation was observed.Conclusion.The administration of RTX + DMARD in patients with RA with resolved HBV infection leads to a negligible risk of HBV reactivation, thus suggesting that serum HBsAg and/or HBV DNA monitoring but not universal anti-HBV prophylaxis is justified.

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