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Infantile hepatitis B in immunized children: risk for fulminant hepatitis and long-term outcomes

Yu-Ru Tseng1, Jia-Feng Wu1, Man-Shan Kong2

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Plos One
|November 8, 2014
PubMed

Insights

Infantile hepatitis B in immunized infants can lead to chronic infection. Early onset and specific maternal factors increase the risk of fulminant hepatitis B, necessitating long-term monitoring for complications like liver cancer.

Area of Science:

  • Hepatology
  • Pediatric Infectious Diseases
  • Immunology

Background:

  • Infantile hepatitis B post-neonatal immunoprophylaxis is rare but distinct.
  • This study investigates long-term outcomes and risk factors in immunized infants with hepatitis B.

Purpose of the Study:

  • To analyze long-term outcomes in immunized infants diagnosed with hepatitis B.
  • To identify risk factors associated with infantile hepatitis B, particularly fulminant hepatitis B.

Main Methods:

  • Retrospective analysis of clinical parameters and outcomes in 41 infants with hepatitis B (HBV).
  • Follow-up duration of at least 6 months (median 4.4 years).
  • Assessment of patient survival, hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) status, and complications.

Main Results:

  • 21 cases of fulminant hepatitis (FH) and 20 of non-fulminant hepatitis (NFH) were observed.
  • Younger age of onset (<7 months) and negative maternal HBeAg were risk factors for FH.
  • 47.6% mortality in FH cases; 35% of NFH cases developed chronic HBV infection. One FH survivor developed hepatocellular carcinoma.

Conclusions:

  • Maternal HBsAg positivity/HBeAg negativity and early onset are risk factors for FH in immunized infants.
  • Many infants with FH or NFH develop chronic HBV infection, with early HBeAg seroconversion.
  • Long-term surveillance for hepatocellular carcinoma is crucial for survivors of infantile hepatitis B.
Abstract

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