Public Health

Most foreign-born children should be screened for hepatitis B, new guidelines say

Last Updated: 2009-10-05 12:45:48 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A panel convened by the Hepatitis B Foundation released recommendations on Monday governing the screening, monitoring, and referral of children with chronic hepatitis B.

"Most children with chronic hepatitis B virus infection are asymptomatic and do not generally require treatment," lead author Dr. Barbara A. Haber, from the Children's Hospital of Philadelphia, and colleagues note. "These children are, however, at increased risk for severe complications later in life, including advanced liver disease and liver cancer."

The new guidelines appear in the October 5th online issue of Pediatrics and will be published in the November print issue of the journal.

According to the guidelines, children who should be screened for chronic infection with hepatitis B virus include:

--Children born in an HBV-endemic country, even if they were given hepatitis B vaccine in that country. These include countries in all of Asia and Africa, the South- and mid-Pacific Islands, Europe (Eastern and Mediterranean countries), Greenland, Russia, the Middle East, South America (Amazon Basin), Caribbean, and indigenous populations from the Arctic, Australia, and New Zealand.

--Children born in the US to immigrant parents from endemic areas.

--Infants born to mothers positive for hepatitis B surface antigen.

--Children living in a household with anyone positive for hepatitis B surface antigen.

As for monitoring children newly diagnosed with chronic hepatitis B, the guidelines recommend that the child receive a number of tests at baseline, including liver enzymes, hepatitis B surface antigen, and ultrasound, among others. If these tests are more or less normal, then regular follow-up testing is advised. When abnormal results occur, consultation with a pediatric liver specialist is advised.

Pediatrics 2009.