Unrecognized hepatitis B in pre-screened children with hematologic and oncologic conditions

Autor: Mahjabeen Khan, E. O'Brian Smith, Daniel H. Leung, Donald H. Mahoney, Lekshmi N. Pillai, David C. Ahamba
Rok vydání: 2013
Předmět:
Zdroj: Pediatric Blood & Cancer. 61:865-868
ISSN: 1545-5009
DOI: 10.1002/pbc.24853
Popis: Background This study evaluates the effectiveness and interpretation of hepatitis B (HBV) screening in an at-risk cohort of children with cancer or blood disorders. Procedure We conducted a retrospective epidemiologic analysis of children who screened positive for HBV (HBsAg, HbcAb) from 1999 to 2009 at a quaternary children's hospital, focusing on patients with hematologic and oncologic conditions. Descriptive statistics were generated for demographics and serologies. Follow-up of positive serologies and clinical outcomes were analyzed. Results A total of 12,754 children were screened for HBV. Of 391 that screened positive, 118 had a hematologic or oncologic diagnosis. Leukemia, anemia, and thrombocytopenia comprised 84% of diagnoses. The majority (98%) tested HBcAb positive but only 20% received confirmatory HBV DNA testing. Three patients (13% of those HBV DNA tested) were identified to have chronic disease. HBV was not a known pre-existing condition, and chemotherapy preceded HBV diagnosis in all cases. Conclusions The majority of children with cancer or blood disorders who screened HBV positive did not receive follow-up DNA testing, exposing them to reactivation risk and delaying definitive therapy. HBcAb may be the only indicator of chronic HBV infection and DNA confirmation should be routine. Our findings suggest a significant number of additional patients eligible for HBV treatment may have been identified with reflexive DNA testing. Pediatr Blood Cancer 2014;61:865–868. © 2013 Wiley Periodicals, Inc.
Databáze: OpenAIRE
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