Pediatric fulminant hepatic failure

liver411

[B]in endemic areas of hepatitis B infection[/B]

Hepatitis B virus is a significant cause of fulminant hepatic failure in
infants, find investigators from Taiwan.

In this study, investigators assessed the role of hepatitis B virus (HBV)
infection in pediatric fulminant hepatic failure (FHF) after the launch of
universal HBV vaccination.

The team's findings are published in the January issue of Hepatology.

The team analyzed the data from patients with FHF collected from a
nationwide collaborative study group.

They included children aged 1 month to 15 years who were diagnosed with FHF
between 1985 and 1999.

The investigators determined that HBV infection (hepatitis B surface
antigen (HBsAg) and/or immunoglobulin M hepatitis B core antibody (IgM
anti-HBc) seropositive) accounted for 46% of all the cases of FHF.

The team calculated that the average annual incidence of FHF during the
study period was 0.053 per 100,000 in patients aged 1 to 15 years.
Incidence was 1.29 per 100,000 in those patients age < 1 year.

Approximately, 61% of all FHF cases were infants.

Furthermore, the percentage of HBV infection was higher in infants compared
with children aged 1 to 15 years (57% versus 27%, respectively).

The team calculated that the incidence rate ratios of patients aged < 1
year to those aged 1 to 15 years was 54.2 for HBV-positive FHF and 15.2 for
HBV-negative FHF.
61% of all fulminant hepatic failure cases were infants.
Hepatology

Maternal HBsAg was positive in 97% of the infants with HBV-positive FHF,
and hepatitis B e antigen (HBeAg) was negative in 84% of these infants.

The team found that 74% of all HBV-positive FHF patients and 81% of the
infantile HBV-positive patients had been vaccinated.

Dr Huey-Ling Chen's team concluded, "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".

Hepatology 2004; 39(1): 58-63
07 January 2004