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[Hepatitis B in children]
P M Grosheide1, P H Rothbarth, L J Gerards
1Afd. Inwendige Geneeskunde II, Academisch Ziekenhuis Dijkzigt, Rotterdam.
Insights
Hepatitis B virus (HBV) infection in infancy often leads to chronic illness. A Dutch national immunization program targets neonates to prevent mother-to-child HBV transmission, reducing long-term liver disease risks.
Area of Science:
- Virology
- Immunology
- Public Health
Context:
- Hepatitis B virus (HBV) infection in infancy has a higher likelihood of leading to a chronic carrier state compared to adult infections.
- High endemicity areas, such as Southeast Asia, experience significant HBV transmission from infected mothers to newborns and among children.
- The Netherlands, with low endemicity (0.8% HBsAg-positive pregnant women), has implemented a national immunization program to prevent perinatal HBV transmission.
Purpose:
- To describe risk factors for hepatitis B infection in children in the Netherlands.
- To discuss the immunization strategy for preventing childhood hepatitis B infections and subsequent chronic liver disease.
Summary:
- Infant hepatitis B virus (HBV) infection has a high risk of chronicity.
- A national immunization program in the Netherlands aims to prevent perinatal HBV transmission in neonates.
- Horizontal transmission among children is also a concern, necessitating a comprehensive immunization strategy.
Impact:
- Preventing perinatal and childhood HBV infections reduces the incidence of chronic hepatitis B and associated adult liver disease.
- The national immunization program is crucial for controlling HBV spread in low endemicity settings.
- Understanding transmission routes informs targeted public health interventions for hepatitis B prevention.
Abstract:
Central to immunization programmes is that hepatitis B virus infection in infancy is much more likely to result in the chronic carrier state than if infection occurs in adulthood. In areas of high endemicity like south-eastern Asia most infections occur when chronically infected women transmit hepatitis B virus to their newborns or when chronically infected children transmit the virus to other children. In the Netherlands, the endemicity is considered low; seroprevalence studies showed that 0.8% of the pregnant women are HBsAg-positive. To prevent mother to child transmission of hepatitis B a national immunization program has recently been implemented to prevent perinatal infection in approximately 450 neonates each year. Horizontal transmission of hepatitis B virus also seems possible in children since persistent carriers are found in (medical) centres and institutions for mentally handicapped. Since hepatitis B infections acquired during early childhood are likely to progress to chronicity and liver disease in adult life some risk factors for children in the Netherlands to contract hepatitis B infection are described and the immunization strategy is discussed.