title: Characteristics and outcome of acute infection with hepatitis B virus in children with cancer.
abstract: After an outbreak of hepatitis B virus (HBV) infection in a unit of pediatric oncology, the clinical outcome and HBV markers were followed in 1 child with chronic and 10 children with acute HBV infection for 12 months. Four children had acute hepatitis with jaundice whereas 7 of the infections were subclinical. Ten children had antecedent malignancies and 1 had aplastic anemia. Four patients died of causes unrelated to the hepatitis after periods of 2, 4, 8 and 10 months. All 3 children who were not immunosuppressed at the time of contracting the HBV infection quickly turned negative for hepatitis B surface antigen (HBsAg), whereas only 2 of 8 patients who were immunosuppressed by chemotherapy eventually became HBsAg-negative. The latter 8 patients were also hepatitis B e antigen (HBeAg)-positive. Two of them quickly cleared HBeAg, but 6 remained HBeAg-positive throughout the follow-up. In 6 of 9 patients HBsAg was also detected in saliva. These results suggest that children who are receiving anticancer chemotherapy have an increased risk of remaining HBeAg-positive and secreting HBsAg and possibly HBV in their saliva, which makes them particularly infective.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Hovi
authors.forename: U M
authors.initials: UM
authors.lastname: Saarinen
authors.forename: H
authors.initials: H
authors.lastname: Jalanko
authors.forename: P
authors.initials: P
authors.lastname: Pohjanpelto
authors.forename: M A
authors.initials: MA
authors.lastname: Siimes
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology* / Q000401:mortality; D006511:Hepatitis B Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D016019:Survival Analysis
chemical_list: D006511:Hepatitis B Antigens