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Chronic hepatitis B and C infection in children in New South Wales

Scott Nightingale1, Michael O Stormon, Andrew S Day

  • 1Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, NSW, Australia.

The Medical Journal of Australia
|June 17, 2009
PubMed

Insights

Many children in New South Wales with chronic hepatitis B (HBV) and hepatitis C (HCV) infections are not referred for specialist care. Early intervention is missed, especially for HCV, hindering optimal management of pediatric liver disease.

Area of Science:

  • Pediatric Hepatology
  • Infectious Diseases Epidemiology
  • Public Health

Background:

  • Chronic hepatitis B (HBV) and hepatitis C (HCV) infections in children require specialized care.
  • Understanding the epidemiological and clinical characteristics of pediatric HBV and HCV is crucial for effective public health strategies.

Purpose of the Study:

  • To characterize the epidemiological, clinical, and laboratory features of children diagnosed with chronic HBV or HCV in New South Wales (NSW).
  • To compare referred pediatric cases with statewide notification data to identify gaps in specialist care.

Main Methods:

  • Retrospective record review of HBV and HCV cases in children (<18 years) referred to NSW tertiary pediatric and refugee clinics (2000-2007).
  • Analysis included epidemiological, clinical, laboratory, liver biopsy, and treatment data.
  • Comparison with NSW Health notification data for the same period.

Main Results:

  • 79 children with chronic HBV and 29 with HCV were referred; 930 HBV and 777 HCV cases were reported to NSW Health.
  • Referred HBV cases were predominantly overseas-born; referred HCV cases were mostly Australian-born to mothers with a history of intravenous drug use.
  • Fibrosis was observed in liver biopsies for both HBV and HCV, though advanced disease was uncommon in referred children.

Conclusions:

  • A significant number of children with chronic HBV and HCV in NSW are not referred for specialist medical care.
  • Opportunities for early intervention in the natural history of these infections, particularly HCV, are being missed.
  • Improved referral pathways are needed to ensure timely specialist assessment and management for pediatric liver infections.
Abstract

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