Hepatitis B virus in children of Southeast Asian refugees

Hepatitis B virus in children of Southeast Asian refugees

Since 1975, nearly 1 million persons have entered the United States from Southeast Asia, where hepatitis B virus infection is hyperendemic. In Southeast Asia, infection with hepatitis B virus often occurs early in life, either through perinatal or child-to-child transmission.

The earlier in life that the infection occurs, the greater the risk of the development of the chronic carrier state, hepatocellular cancer or liver damage. Therefore, prevention of hepatitis B virus infection in young children becomes even more important. Routine screening for hepatitis B surface antigen in pregnant women of Asian descent has been recommended since 1984. In addition, prophylactic immunization of infants born to women infected with hepatitis B virus has been recommended since 1981.

Whether child-to-child transmission remains a problem after Southeast Asians resettle in the United States is not clear. To evaluate the prevalence and patterns of transmission of hepatitis B virus infection among the children of refugees from Southeast Asia, Franks and colleagues studied 257 U.S.-born children in 196 refugee families.

Of the 31 children born to mothers with infectious disease, 17 (55 percent) were infected with hepatitis B virus. Of 226 children whose mothers did not have infectious disease, 15 (7 percent) had evidence of hepatitis B virus infection. Nearly half (46 percent) of the 32 cases of infection in children were not attributable to perinatal transmission. The risk of infection was greater among children living in households with other infected children.

The authors believe that child-to-child transmission remains an important route of hepatitis B transmission in Southeast Asian refugees living in the United States. They recommend that current vaccination guidelines for hepatitis B virus be revised to include the vaccination of all newborns of Southeast Asian immigrants. (New England Journal of Medicine, November 9, 1989, vol. 321, p. 1301.)

COPYRIGHT 1990 American Academy of Family Physicians

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