Investigating Hepatitis B Immunity In Children with with newly diagnosed Acute Lymphoblastic Leukemia presenting at a Tertiary Cancer Care Centre
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 8
Abstract
Hepatitis B is a dreaded infectious disease and one of the major global public health problems .In India, the prevalence of hepatitis B surface antigen (HBsAg) among the general population ranges from 2% to 8%, placing India in an intermediate HBV endemicity zone. Waning of vaccine induced immunity leaves people at risk of acquiring hepatitis B infection in settings where the prevalence of infection is high .Vaccine-induced seroprotection (AntiHBs) is another useful surrogate of vaccine efficacy.Our purpose in this study was to assess the immunity to Hepatitis B virus in children presenting with newly diagnosed Acute Lymphoblastic Leukemia to the Paediatric Oncology Division of Regional Cancer Centre ,Thiruvanathapuram. Data regarding primary immunization were collected from immunization card. AntiHBsAg titers were estimated in each child at the time of presentation. Patients were classified as immune (antibody levels to hepatitis B surface antigen (anti¬HBs) >100mIU/ml), low immune (anti¬HBs10-100mIU/ml) and not immune (anti¬HBs <10 mIU/ml). Of the 109 children included (median age 5.6 years), 75(68.8%) children had protective antiHBs titres (>10IU/L),34 (31.2%) children had no immunity to hepatitis B despite presumed vaccination as part of the UIP schedule. Of the 75 children with protective antiHBs titres 37 children (49.33%) had low immune antiHBstitres(10-100mIU/ml) and 38 children (50.66%) had immune antiHBstitres > 100 mIu/ml.None of the children had active hepatitis B infection (hepatitis B surface antigen ¬positive)at presentation. A significant number of children lack protective anti HBs titres despite being vaccinated according to Universal Immunization Programme and are at risk of hepatitis B infection. Active surveillance and continued screening for HBV must be done at first presentation for all children and may be continued during treatment if clinically indicated. The use of combined passive-active immunisation should be encouraged, especially in children with haematological malignancies.
Authors and Affiliations
Prasanth VR, Priyakumari T
Keywords
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