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[Predisposition of Down syndrome to chronic infection with the hepatitis B virus]
M J Rua Armesto1, V Ramírez Marín, M T Onaindia Ercoreca
1Servico de Pediatría, Fundación Jiménez Díaz, Universidad Autónoma, Madrid.
Insights
Children with Down's syndrome (DS) are highly susceptible to hepatitis B virus (HBV) infection, often leading to chronic carrier status. Early HBV vaccination before school entry is crucial for this population.
Area of Science:
- Hepatology
- Infectious Diseases
- Pediatrics
Context:
- Down's syndrome (DS) population
- Hepatitis B virus (HBV) infection prevalence
- Mental retardation
Purpose:
- Determine HBV infection age in DS
- Assess chronic carrier incidence in DS
- Identify optimal HBV vaccination age for DS
Summary:
- A study analyzed HBV markers in 302 children (DS and other mental retardation).
- DS schoolchildren showed higher HBV marker prevalence (58%) and chronic carrier rates (40%) compared to OMR children (25% and 17%).
- DS children frequently maintain HBV replication, indicating a significant public health concern.
Impact:
- Highlights increased HBV susceptibility and chronicity in DS.
- Recommends pre-school HBV vaccination for children with DS.
- Suggests prompt antiviral treatment for DS individuals with HBV replication.
Abstract:
In order to know in Down's Syndrome (DS) the age of infection by hepatitis B virus (HBV), the incidence of evolution to a chronic carrier status and the optimal age for vaccination against this virus, a study of the prevalence of HBV-markers was carried out in 302 mentally retarded children: Group I, 51 pre-schoolchildren with DS (mean age 2.9 +/- 1.6 years); Group II, 72 schoolchildren with DS (mean age 13.8 +/- 3 years) and Group III, 179 schoolchildren with other types of mental retarded (OMR). Children from group II and III attended the same school as external day-pupils. Fifty eight percent of schoolchildren with SD presented at least one HBV-marker while this percentage was of 25% in schoolchildren with OMR (p > 0.05) or pre-schoolchildren with DS (p > 0.005); DS schoolchildren become also HBV chronic carrier with higher frequency than ORM schoolchildren (40 vs 17) (p > 0.05) and they maintained HBV replication in a higher proportion of cases (36 vs 4) (p > 0.05). In conclusion children with DS acquire easily HBV infection and this occurs when they attend the school independently that the school is a closed or an open institution. They also become more frequently HBV chronic carriers and they maintain HBV replication; so, they must be vaccinated before they begin to attend school and they must be treated with antiviral agents as soon as possible.