Investigating hepatitis B immunity in patients presenting to a paediatric haematology and oncology unit in South Africa
BACKGROUND: Hepatitis B is an important public health concern in South Africa (SA). The hepatitis B virus (HBV) vaccine was introduced into the South African Expanded Programme on Immunisation (EPI-SA) in 1995. There is no 'catch-up' programme in place. The duration of protection after hepatitis B vaccination in the SA population is unknown. Waning of vaccine-induced immunity leaves people at risk of acquiring hepatitis B infection in settings where the prevalence of infection is high and horizontal transmission is likely. OBJECTIVE: To assess immunity to HBV in patients at presentation to a paediatric haematology and oncology unit. METHODS: An audit of hepatitis profiles was done of all new patients seen in the unit from January 2012 to December 2013. Patients were classified as immune (antibody levels to hepatitis B surface antigen (anti-HBs) <img border=0 width=32 height=32 src="../../../../../img/revistas/samj/v104n9/20s1.jpg">100 mIU/ml), low immune (anti-HBs 10 - 100 mIU/ml) and not immune (anti-HBs <img border=0 width=32 height=32 src="../../../../../img/revistas/samj/v104n9/20s2.jpg">10 mIU/ml). RESULTS: Of the 210 patients included (median age 6.5 years), 84 (40.0%) had no immunity to hepatitis B despite presumed vaccination as part of the EPI schedule. Six patients tested positive for hepatitis B core antibody (anti-HBc), consistent with previous infection. No patients had active hepatitis B infection (hepatitis B surface antigen-positive). Most human immunodeficiency virus (HIV)-infected patients were not immune to HBV (80.0%). CONCLUSION: A significant number of children in SA are not immune to hepatitis B despite vaccination being part of the EPI-SA. Combined passive-active immunisation should be considered for all oncology patients in settings where exposure to HBV is possible. Consideration should also be given to offering booster vaccination to the population as a whole.
| Main Authors: | , , , |
|---|---|
| Format: | Digital revista |
| Language: | English |
| Published: |
South African Medical Association
2014
|
| Online Access: | http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742014000900020 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|