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[Adoption and chronic hepatitis B carrier state]
J J Choulot1, S Mechain, J Saint Martin
1Service de pédiatrie, centre hospitalier général de Pau, France.
Insights
International adoption can expose children to chronic hepatitis B virus (HBV) infection. Early screening and preventive measures are crucial for adopted children
Area of Science:
- Pediatric Infectious Diseases
- Hepatology
- Public Health
Context:
- International adoption has increased in France due to a shortage of adoptable children domestically.
- Internationally adopted children often present with significant health issues upon arrival.
- Hepatitis B virus (HBV) infection is a growing concern among this population.
Purpose:
- To investigate the prevalence of hepatitis B virus (HBV) infection in internationally adopted children.
- To identify risk factors and co-infections associated with HBV in adopted children.
- To assess the health status of internationally adopted children, focusing on HBV.
Summary:
- A study of 60 internationally adopted children revealed that 6 (10%) were chronic HBV carriers.
- Of the carriers, 5 had detectable HBV DNA, and one was co-infected with the delta virus.
- Elevated aminotransferase levels were observed in half of the HBV-positive children.
Impact:
- Highlights the risk of chronic HBV infection in internationally adopted children, particularly those from high-prevalence regions or with extended stays in Eastern European institutions.
- Emphasizes the potential for transmission within families and educational settings, necessitating prompt screening and vaccination.
- Underscores the importance of implementing preventive strategies to mitigate the public health impact of HBV in this vulnerable group.
Aim:
Because there are few adoptable children in France, parents, for the last 20 years, have turned to international adoption. Alerted by the generally poor health of these children, we paid particular attention to their health problems and especially to infection by hepatitis B virus (HBV).
Population And Methods:
The 60 internationally-adopted children seen from June 1993 to June 1997 were included in this study. All had hemogram and serum iron dosage, and search for intestinal parasites and tuberculosis was performed in each child, as were HBs antigen and HBs antibody screening. When HBs antigen was positive, HBe antigen and antibodies, HBV DNA and hepatitis C and delta serology were also studied.
Results:
Six out of the 60 children were HBV chronic carriers. The six presented HBs antigen and five out of the six presented viral DNA. One child was co-infected with delta virus. Serum aminotransferase was normal in three children and increased in the three others.
Discussion:
Some internationally adopted children are exposed to chronic infection by HBV. This concerns children coming from countries known for the high frequency of the disease, but also children with long stay in Eastern European nurseries. Chronic HBV carriage puts the child, as well as the family and other children in institutions and/or schools at risk, thus necessitating preventive measures.