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Changing aetiologic patterns of acute viral hepatitis in Taiwanese children
L M Huang1, M H Chang, J Y Hong
1Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Hepatitis B and A cases in Taiwanese children decreased due to vaccination and improved hygiene. Non-A, non-B hepatitis control requires further efforts.
Area of Science:
- Pediatrics
- Hepatology
- Epidemiology
Background:
- Acute viral hepatitis is a significant pediatric health concern.
- Hepatitis B and A are common causes of acute hepatitis in children.
- Understanding etiological patterns is crucial for public health interventions.
Purpose of the Study:
- To analyze the etiological patterns of acute viral hepatitis in children in Taiwan.
- To identify trends in hepatitis A, B, and non-A, non-B hepatitis over a six-year period.
- To evaluate the impact of public health initiatives on hepatitis incidence.
Main Methods:
- Retrospective analysis of 76 pediatric acute viral hepatitis cases.
- Data collected from National Taiwan University Hospital (1981-1986).
- Review of transmission modes for hepatitis B virus (HBV) and hepatitis A virus (HAV).
Main Results:
- Hepatitis B accounted for the majority (64%) of cases, primarily acquired in infancy.
- Perinatal transmission and blood transfusions were key HBV transmission routes.
- Hepatitis A cases peaked in 1982 due to an outbreak, then declined; Hepatitis B cases declined post-1984 following vaccination.
- Non-A, non-B hepatitis frequency remained stable.
Conclusions:
- The etiological pattern of acute hepatitis in Taiwanese children has shifted.
- Effective control measures have reduced hepatitis A and B incidence.
- Further strategies are needed to control non-A, non-B hepatitis.
Abstract:
During 1981-86, 76 children were diagnosed as having acute viral hepatitis at the Department of Pediatrics, National Taiwan University Hospital, which is a major referral centre for hepatitis in children in northern Taiwan. The majority (64%) of children had acute hepatitis B which had occurred mainly during infancy. Perinatal transmission from a hepatitis B e negative surface antigen (HBsAg) carrier mother or infection through blood transfusion from a donor who had escaped notice by a less sensitive screening test (reverse passive haemagglutination test) for HBsAg were the two important modes of transmission of hepatitis B virus. The number of cases of acute hepatitis B declined after 1984, with the beginning of the nation-wide hepatitis B vaccination programme. Due to an outbreak of hepatitis A in northern Taiwan in 1982, the number of cases of hepatitis A peaked that year. Subsequently, cases of acute hepatitis A decreased remarkably. Better socio-economic conditions and improved hygiene might have contributed to the marked decrease of viral hepatitis A. The frequency of non-A, non-B hepatitis remained stable during the study period. It is possible to conclude that the aetiologic pattern of acute hepatitis in Taiwanese children changed during the past 6 years: clinical cases of hepatitis A and B decreased, probably because of more effective control of hepatitis A and B virus infections, whereas the control of non-A, non-B virus apparently requires further efforts.