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Need for immunization against hepatotropic viruses in children with chronic liver disease

Anshu Srivastava1, Amrita Mathias, Surender Kumar Yachha

  • 1*Departments of Pediatric Gastroenterology †Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Journal of Pediatric Gastroenterology and Nutrition
|May 21, 2014
PubMed

Insights

Children with chronic liver disease (CLD) show high exposure rates to hepatitis A, B, and E viruses. Targeted hepatitis A vaccination for younger children and universal hepatitis B vaccination are recommended for CLD patients.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Infectious Diseases

Background:

  • Hepatotropic viral infections are a significant cause of acute deterioration and poor outcomes in children with chronic liver disease (CLD).
  • Vaccination presents a potential strategy to prevent superimposed viral infections in this vulnerable pediatric population.

Purpose of the Study:

  • To determine the seroprevalence of hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis E virus (HEV) in children diagnosed with CLD.
  • To inform and propose an optimal vaccination strategy for preventing these viral infections in children with CLD.

Main Methods:

  • Prospective evaluation of children with CLD using a detailed proforma.
  • Serological testing for exposure to HAV (total anti-HAV, IgM anti-HAV), HBV (HBsAg, total anti-HBc, anti-HBs), and HEV (IgG anti-HEV).
  • Classification of CLD into HBV-CLD and non-HBV-related CLD based on hepatitis B surface antigen status.

Main Results:

  • Out of 142 children with CLD, 90.8% had prior exposure to HAV, with higher rates in those older than 5 years.
  • 39.1% of children with non-HBV-related CLD showed evidence of HBV exposure.
  • 19.7% of the total cohort had been exposed to HEV, with no significant age-related difference.

Conclusions:

  • High seroprevalence of HAV, HBV, and HEV infections in children with CLD necessitates targeted prevention strategies.
  • Selective hepatitis A vaccination for children under 5 and universal hepatitis B vaccination are crucial for protecting this cohort.
  • Improvements in sanitation and the development of an HEV vaccine are needed for comprehensive prevention.
Abstract

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