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Hepatitis A in internationally adopted children: screening for acute and previous infections
Roohi Y Abdulla1, Marilyn A Rice, Stephanie Donauer
1Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
Insights
Hepatitis A virus (HAV) immunity in internationally adopted children varies significantly by age and country of origin. Screening is recommended to guide HAV immunization and prevent household transmission.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Internationally adopted children may have varying exposure to infectious diseases.
- Hepatitis A virus (HAV) infection is a significant public health concern globally.
- Understanding HAV immunity is crucial for adopted children arriving in new environments.
Purpose of the Study:
- To determine the prevalence of acute hepatitis A virus (HAV) infection.
- To assess HAV immunity levels among internationally adopted children.
- To identify factors influencing HAV immunity in this population.
Main Methods:
- Serological testing for HAV infection and immunity was performed on eligible children.
- Data were collected on children's age and country of origin.
- Prevalence rates were calculated based on age and region.
Main Results:
- 29% of children showed positive HAV serological results, with immunity varying by region (17% in Asia/Pacific Rim to 72% in Africa).
- Immunity increased significantly with age, from 13% in children under 2 years to 80% in those aged 12-17 years.
- Acute HAV infection was detected in 1% of children, with one case of household transmission noted.
Conclusions:
- HAV immunity in internationally adopted children is strongly influenced by age and country of origin.
- Screening for HAV is valuable for assessing immunization needs.
- Screening aids in preventing HAV transmission to family and close contacts.
Objective:
The goal was to determine the prevalence of acute hepatitis A virus (HAV) infection and immunity among internationally adopted children.
Methods:
Children seen at the International Adoption Center between September 25, 2006, and September 30, 2008, and were screened for HAV within 4 months after their arrival in the United States were eligible for the study. The age- and country-specific prevalence of acute HAV infection and immunity were determined.
Results:
Overall, 288 children underwent HAV serological testing. Of the 279 with total HAV serological results, 29% had positive findings. Immunity varied according to region and country. The prevalence was lowest among children born in Asia/Pacific Rim region (17%) and highest among children born in Africa (72%). Only 13% of children <2 years of age were immune, compared with 80% of children 12 to 17 years of age (P = .002). Increasing age and birth region were associated independently with immunity. Positive HAV immunoglobulin M test results were found for 3 (1%) of 270 children; all were without symptoms. Their ages were 18, 27, and 41 months, and they were born in Kazakhstan, Russia, and the Latin America/Caribbean region, respectively. The father of 1 child developed HAV infection after arriving home.
Conclusions:
HAV immunity among internationally adopted children varied according to age and country of origin; 1% had acute infections. HAV screening is useful for determination of the need for HAV immunization and for prevention of transmission to family members and close contacts.
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