[Systematic review and meta-analysis of epidemiology, prophylaxis and therapy of infections with viral hepatitis B and C in Polish paediatric oncology centres].
OBJECTIVE
Summary of published data on epidemiology, prophylaxis and therapy of HBV and HCV infections in Polish paediatric oncology centres.


METHODS
Metaanalysis of available data from 1985-2008.


RESULTS
1. Epidemiology of HBV/HCV infections in 2070 patients. HBV infections in 716/1735 (41.3%), HCV in 497/1557 (31.9%), dual HBV+HCV in 76/707 (10.7%) patients. 2. Documented vaccinations against HBV infections before introduction of neonate vaccination in 1995 were carried out in 1056 children. In 614/985 (62.3%) patients seroconversion was detected, but 62/792 (7.8%) patients became infected. 3. Therapy with interferon was introduced in 188 patients; 89 with HBV, 41 with HCV and 58 with HBV+HCV. Response to interferon therapy defined as inhibition or decrease of viral replication or elimination of viral markers was documented in 37/188 (19.6%) patients. Alanine transaminase normalization occurred in 127/168 (75.6%) patients. 4. Protective effect against HBV infection after neonates/infants vaccination in 1995 was analyzed in 392 patients. Protective effect was obtained in 339/392 (86.5%) children, while infection with HBV occurred in 28/392 (7.1%) patients. During this period HCV infection was detected in 1/159 patients. No dual infections were found.


CONCLUSIONS
Introduction of active immunoprophylaxis against HBV infections in haematology/oncology wards in 1989-1992, has led to 10-fold (p<0.00001), decrease of risk of HBV infection, and obligatory vaccination of infants/neonates in l995 additionally decreased the risk by 4-fold (p<0.00001). After introducing all prophylaxis measures, the risk of HBV infection decreased 38-fold (p<0.00001). Vaccination of neonates/infants has decreased 8-fold (p<0.00001), the risk of lack of anti-HBV. The risk of HCV infection decreased 74-fold (p<0.00001) in the same period. No risk of dual HBV+HCV infections was found currently.
Styczyński
Jan
J
Katedra i Klinika Pediatrii, Hematologii i Onkologii, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet im. Mikołaja Kopernika, ul. Curie-Skłodowskiej 9, 85-094 Bydgoszcz, Poland. jstyczynski@cm.umk.pl
Kruszewska
Natalia
N
Wysocki
Mariusz
M
D002648:Child; D015897:Comorbidity; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000628:therapy*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D011044:Poland / Q000453:epidemiology; D012074:Remission Induction
D017325:Hepatitis B Vaccines; D007372:Interferons