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Severe hepatitis B in infants born to HBsAg carrier mothers
Insights
Severe hepatitis B in infants born to carrier mothers can lead to acute liver failure. Prompt exchange transfusion and supportive care may improve survival rates for these infants.
Area of Science:
- Pediatrics
- Hepatology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection in infants born to HBsAg-positive mothers poses a significant risk.
- Neonatal HBV infection can progress to severe hepatitis and acute liver failure.
- Hepatitis B immune globulin (HBIG) is used for prophylaxis, but outcomes in severe cases require further investigation.
Purpose of the Study:
- To evaluate the efficacy of exchange transfusion and supportive care in infants with severe hepatitis B.
- To analyze the outcomes of infants born to HBsAg carrier mothers who developed acute liver failure.
Main Methods:
- Retrospective analysis of five consecutive infants with severe hepatitis B.
- Treatment included exchange transfusion, correction of coagulation defects, and intensive supportive measures.
- All infants were born to HBsAg carrier mothers; one received HBIG post-birth.
Main Results:
- Three out of five infants survived with full recovery.
- Two infants died from hepatic encephalopathy within one to two weeks of admission.
- Initial symptoms included vomiting, loose stools, and low-grade fever, progressing to liver failure.
Conclusions:
- Early recognition of hepatic failure is crucial for timely intervention.
- Exchange transfusion combined with intensive supportive treatment may improve survival in severe neonatal hepatitis B.
- Despite interventions, mortality remains a concern in fulminant hepatic failure cases.
Abstract:
Five infants admitted consecutively with severe hepatitis B were treated with exchange transfusion, correction of coagulation defects and supportive measures. All were born to HBsAg carrier mothers and one had received hepatitis B immune globulin (HBIG) within 24 hours after birth. All of them presented with nonspecific symptoms such as vomiting, loose stools, low grade fever and progressed to acute liver failure. Three of them survived with full recovery and two died from hepatic encephalopathy one and two weeks after admission. Early recognition of hepatic failure and prompt exchange transfusions with intensive supportive treatment may save these infants.