Persistent Hepatitis B Virus Replication After Survival of Fulminant Hepatitis and Clearance of HBsAG

Wirth, Stéfan; Gerner, Patrick; Oettinger, R.; Friedt, Michael; Truebel, Hubert

doi:10.1097/00005176-200201000-00018

Cited by 2 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, one patient in this study had HBsAg clearance and anti-HBs positivity 1 month after diagnosis of FH, but HBsAg reappeared 3 months later, indicating failure of host immune response to clear the virus. Viral replication 7 years after survival of fulminant hepatitis and the clearance of HBsAg has been reported in a case with infantile fulminant hepatitis B [30]. Interestingly, in the NFH group, lower ALT levels were associated with chronicity.…”

Section: Discussionmentioning

confidence: 82%

Infantile Hepatitis B in Immunized Children: Risk for Fulminant Hepatitis and Long-Term Outcomes

Tseng

Kong

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

BackgroundInfantile 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.MethodsThe clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBV-positive 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.ResultsAmong 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.ConclusionsMaternal 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.

show abstract

Section: Discussionmentioning

confidence: 82%

Infantile Hepatitis B in Immunized Children: Risk for Fulminant Hepatitis and Long-Term Outcomes

Tseng

Kong

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Prevention and control of infection, with particular reference to hepatitis B virus (HBV), has been improved since the recommendations of the Rosenheim report in the UK in 1972 (DOH, 1972) and the "Good practice guidance for renal dialysis/transplantation units" (Wirth et al, 2002) from the Department of Health in 2002, respectively. These included the introduction of regular hepatitis B surface antigen (HBsAg) screening, hepatitis B immunisation for health care workers (HCW) and renal unit attendees, introduction of disposable dialysis cartridges and emphasis on good infection control practices.…”

Section: Introductionmentioning

confidence: 99%