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884 The Variability in the Course of Hepatitis B in Children After Mother-To-Child Transmission as a Reason to Adjust Treatment
  1. B Kowalik-Mikołajewska1,2,
  2. M Aniszewska1,2,
  3. M Marczyńska1,2
  1. 1Department of Children’s Infectious Diseases, Medical University of Warsaw
  2. 2Hospital of Infectious Diseases, Warsaw, Poland

Abstract

Background and Aims In Poland currently, despite obligatory hepatitis B vaccination we expect the occurence of mother-to-child infection. We present 3 different courses of the HBV mother-to-child infections as a basis to differentiation of the therapeutic models .

Methods We investigated case reports of 3 children infected with HBV by their mothers HBsAg(+) HBeAg(+). Chronic hepatitis B was confirmed in mothers aged 18, 21 and 26 respectively. All children were vaccinated against hepatitis B at delivery: two of them three times, one two times. One of the children was administered HBIG in the first day of its life.

Results Hepatitis B virus infection in 2 children was revealed in the 3rd year of life. Acute hepatitis with the Gianotti-Crosti syndrome was diagnosed in 1 child in the 6th month of life. Subsequently, all children were diagnosed with chronic hepatitis B and the course of the disease was different in each case. In the first child aged 1, the activity of alanine aminotransferase decreased to near normal level with the seroconversion of HBe antigen to antibodies anti-HBe. The second child in the fourth year of life has high level of HBV viral load and high activity of alanine aminotransferase. The third child (12 years old) has exacerbation of disease after failure of treatment (lamivudine, interferon twice).

Conclusions 1. The course of chronic hepatitis B in children after maternal infection may be vary, therefore some adjustments in treatment should be taken into account.

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