Abstract
Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05) than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8%) and genotype A (4%). In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.
Highlights
Viral hepatitis is a leading cause of chronic liver disease and a serious public health problem in children worldwide
From 215 children with clinical hepatitis included in this study, 45 cases (21%) were re-tested by the confirmatory polymerase chain reaction (PCR) assay to confirm hepatitis B virus (HBV) infection
Among the HBV DNA+ children, 54% were positive for anti-hepatitis A virus (HAV) IgM antibody, though none were positive for anti-hepatitis C virus (HCV) antibody
Summary
Viral hepatitis is a leading cause of chronic liver disease and a serious public health problem in children worldwide. Occult hepatitis B in Mexican children Griselda Escobedo-Melendez et al 729 and several high-prevalence regions for HBV infection have been identified throughout the country (Roman et al 2010). This epidaemiological pattern is the common scenario for OBI infection, which may be underestimated due to the immunological response of Mexicans to HBV genotype H (Fierro et al 2011) or to a lack of sensitivity of the HBsAg assay (Roman et al 2009). This study was aimed to analyse the clinical and molecular characteristics of HBV infection in children, which may contrast to what has been reported in adults
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