Hepatitis B in children with leukemia: the role of primary immunization
DOI:
https://doi.org/10.18203/2349-3291.ijcp20192028Keywords:
Hepatitis B, Leukemia, Primary immunizationAbstract
Background: Children with cancer have a greatly enhanced risk of contracting hepatitis B infection due to immunosuppression secondary to chemotherapy and radiotherapy, frequent blood transfusions, bone and peripheral vein punctures, tissue damage and mucositis. During the past 3 decades, multimodality therapy for childhood leukemia has resulted in markedly improved survival. Inspite of screening and immuno prophylaxis, hepatitis B infection rates in children with leukemia are high. In view of this, we decided to study the prevalence of hepatitis B among children with leukemia in our institution, and the possible risk factors.
Methods: This was a cross sectional study carried out at a tertiary pediatric care center in North Kerala among 104 children between 1 and 12 years of age on treatment for leukemia.
Results: Among the 104 children, only 17 (16.3%) had received primary immunization against hepatitis B. Of the 87 children who had not received primary immunization, 44.8% (n=39) developed hepatitis B, compared to 11.8% (n=2) in the vaccinated group (p=0.01).
Conclusions: This study highlights the importance of primary immunization against hepatitis B in children with leukemia, and the need for universal coverage.
References
Riyaz A. Viral hepatitis. In: Pediatric gastroenterology and hepatology. 4th edition. Hyderabad: Paras medical publishers. 2019:427-456
Styczynski J, Wysocki M, Koltan S, Kurylak A. Epidemiologic aspects and preventive strategy of hepatitis B and C viral infections in children with cancer. Pediatr Infec Dis J. 2001;20(11):1042-9.
Mostafa A, Ebeid E, Mansour TA, Amin MA, Sidhom I, Khaeiry A, et al. Seroprevalence of hepatitis B and C in pediatric malignancies. J Egyptian National Cancer Institute. 2003;15:33-42.
Sarin SK, Kumar M. HBV prevalence, natural history, and treatment in India and Indian Americans in the United States. Curr Hepatitis Rep. 2009;8(1):31-8.
Qamer S, Shahab T, Alam S, Malik A, Afzal K. Age-specific prevalence of hepatitis B surface antigen in pediatric population of Aligarh, North India. Ind J Pediatr. 2004;71(11):965-7.
Goyal S, Pai SK, Kelkar R, Advani SH. Hepatitis B vaccination in acute lymphoblastic leukemia. Leukemia Res. 1998;22(2):193-5.
Somjee S, Pai S, Kelkar R, Advani S. Hepatitis B vaccination in children with acute lymphoblastic leukemia: results of an intensified immunization schedule. Leukemia Res. 1999;23(4):365-7.
Baytan B, Gunes AM, Gunay U. Efficacy of primary hepatitis B immunization in children with acute lymphoblastic leukemia. Indian Pediatr. 2008;45(4):265.
Tuphan KD, Manoranjan M. Efficacy of immunization against hepatitis B virus infection in acute leukemia. Turk J Hematol. 2010;27(3):156-61
Ramesh M, Marwaha RK, Chawla YK, Trehan A. Seroconversion after hepatitis B vaccination in children receiving cancer chemotherapy. Indian Pediatr. 2000;37(8):882-5.
Entacher U, Jürgenssen O, Thun-Hohenstein L, Simbruner G, Khoss A, Wank H, et al. Hepatitis B vaccination and immune response in children with malignant diseases. Eur J Pediatr. 1985;144(2):160-3.
Somjee S, Pai S, Parikh P, Banavali S, Kelkar R, Advani S. Passive active prophylaxis against Hepatitis B in children with acute lymphoblastic leukemia. Leukemia Res. 2002;26(11):989-92.
Meral A, Sevinir B, Günay Ü. Efficacy of immunization against hepatitis B virus infection in children with cancer. Medical and Pediatric Oncology: The Official Journal of SIOP-Int Soc Pediatr Oncol. 2000;35(1):47-51.
Saxena R, Thakur V, Sood B, Guptan RC, Gururaja S, Sarin SK. Transfusion–Associated Hepatitis in a Tertiary Referral Hospital in India. Vox sanguinis. 1999;77(1):6-10.
Hsu SC, Chang MH, Ni YH, Hsu HY, Lee CY. Horizontal transmission of hepatitis B virus in children. J Pediatr Gastroenterol Nutr. 1993;16(1):66-9.