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[Prevention of hepatitis B by passive immunization of children with chronic hematologic disease immunoglobulin]
R Rokicka-Milewska1, E Kacperska, Z Moraczewska
1Katedry i Kliniki Pediatrii, Hematologii i Onkologii Ak. Med. w Warszawie.
Insights
Hepatitis B immunoglobulin (Hepatect) was administered to children with cancer or aplastic anemia. Three of 52 children contracted hepatitis B virus (HBV) infection, suggesting potential for dose adjustments to improve prevention.
Area of Science:
- Pediatric Oncology
- Immunology
- Infectious Disease Prevention
Context:
- Children undergoing intensive chemotherapy for leukaemias, lymphomas, and testicular tumours are at high risk of infections.
- Aplastic anemia patients receiving immunosuppressive therapy also face increased infection risks.
- Hepatitis B virus (HBV) infection poses a significant threat to immunocompromised pediatric patients.
Purpose:
- To evaluate the efficacy of intravenous hepatitis B immunoglobulin (Hepatect) in preventing HBV infection in high-risk pediatric patients.
- To assess antibody concentration fluctuations and infection rates during prophylaxis in children with various hematologic and oncologic conditions.
Summary:
- A study involving 66 children (6 months-14 years) with leukaemias, lymphomas, testicular tumours, or aplastic anemia received monthly intravenous Hepatect.
- Antibody concentrations showed fluctuations; 3 out of 52 analyzed children (5.76%) were infected with HBV despite prophylaxis.
- Low anti-HBs antibody levels were observed in some children, indicating potential for breakthrough infections.
Impact:
- The findings highlight the need for careful monitoring of anti-HBs antibody levels in immunocompromised children receiving prophylaxis.
- Results suggest that optimizing Hepatect dosage and administration frequency may be necessary to further reduce HBV infection incidence.
- This research contributes to understanding prophylaxis effectiveness in vulnerable pediatric populations undergoing intensive medical treatments.
Abstract:
In order to prevent the hepatitis virus B (HBV) infection, in 66 children aged from 6 months to 14 years with acute and chronic leukaemias, Hodgkin's and non-Hodgkin's lymphomas, testicular tumours, and aplastic anaemia a specific immunoglobulin was used intravenously (Hepatect made by Biotest). Hepatect was given every month to children with proliferative diseases throughout the whole time of intensive chemotherapy, and to children with aplastic anaemias during the administration of antilymphocytic globulin, prednisone, and Anapoln. Fourteen children were excluded from the analysis due to lack of systematic follow-up. Among 52 studied children, in most cases considerable fluctuations were observed of antibody concentration, the maximal values of which were of 150 mIU/ml. In 35 children, with the exception of sporadic falls, the anti-HBs antibody level remained level was noted, in two cases the presence of antibodies was revealed only sporadically. One of these children was infected with HBV. In all, three children were infected (5.76% of all children in the studied group). Perhaps the use of higher doses of Hepatect and its more frequent administration in children showing low anti-HBs level after routine doses might reduce further the incidence of infection.