title: Hepatitis B virus infection in native versus immigrant or adopted children in Italy following the compulsory vaccination.
abstract: BACKGROUND
  Compulsory vaccination of children against hepatitis B virus (HBV) infection was introduced in Italy in 1991.
  
  
  METHODS
  To evaluate the current importance of pediatric HBV infection, we studied 359 HBsAg-positive children admitted to 16 centers in Italy from 1991 to 1998. 185 patients were natives of Italy and 174 (39 immigrants and 135 adopted) came from highly endemic countries (eastern Europe: 60.9%, Asia: 16.7%, Africa: 14.9% and Central and South America: 5.7%).
  
  
  RESULTS
  Transaminase Levels were moderately altered in both Italian (mean 134 UI/L) and foreign children (mean 168 UI/L). In total, 77% of ItaLian children and 88% of foreign children tested HBeAg positive. High transaminase levels and HBeAg positivity were more frequent in adopted children. Follow-up of 317 patients showed that the incidence of HBeAg/anti-HBe serum conversion was similar in all cohorts, but in adopted children it occurred at an earlier age and was associated with HBsAg clearance in 5%.
  
  
  CONCLUSIONS
  HBV is not frequent in Italian children today, but it is common among children coming from highly endemic areas. The vaccination of nonimmune native populations must be strongly recommended.
authors.affiliation: Infectious Diseases Unit Giannina Gaslini Children's Hospital, Genova, Italy. raffaellagiacchino@ospedale-gaslini.ge.it
authors.forename: R
authors.initials: R
authors.lastname: Giacchino
authors.forename: L
authors.initials: L
authors.lastname: Zancan
authors.forename: P
authors.initials: P
authors.lastname: Vajro
authors.forename: G
authors.initials: G
authors.lastname: Verucchi
authors.forename: M
authors.initials: M
authors.lastname: Resti
authors.forename: C
authors.initials: C
authors.lastname: Barbera
authors.forename: A
authors.initials: A
authors.lastname: Maccabruni
authors.forename: M
authors.initials: M
authors.lastname: Marcellini
authors.forename: F
authors.initials: F
authors.lastname: Balli
authors.forename: A
authors.initials: A
authors.lastname: Cascio
authors.forename: G
authors.initials: G
authors.lastname: Nebbia
authors.forename: C
authors.initials: C
authors.lastname: Crivellaro
authors.forename: F
authors.initials: F
authors.lastname: Bortolotti
authors.forename: M G
authors.initials: MG
authors.lastname: Clemente
authors.forename: P
authors.initials: P
authors.lastname: Bragetti
authors.forename: P
authors.initials: P
authors.lastname: Valentini
authors.forename: N
authors.initials: N
authors.lastname: Mazzoni
authors.forename: G
authors.initials: G
authors.lastname: Losurdo
authors.forename: E
authors.initials: E
authors.lastname: Cristina
mesh_terms: D000293:Adolescent; D000300:Adoption; D002648:Child; D002675:Child, Preschool; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines