Hepatitis B vaccination of children and adolescents

In the 14 years that have passed since its introduction, the hepatitis B vaccine has proved to be highly immunogenic, effective and very well tolerated. The vaccination, previously performed only in persons at high risk of contracting hepatitis B, in particular medical personnel, has appreciably reduced the incidence of hepatitis B in this group. The incidence of the disease in the general population, however, has been reduced only marginally. Thus, the sole possibility of resolving the hepatitis B problem is to introduce general vaccination. To this end, the The St?ndige Impfkommission (STIKO) has included hepatitis B vaccination in the catalog of vaccinations for children and adolescents. The greatest importance must probably attach to vaccination of young children, in whom hepatitis B vaccination is carried out along the same lines as the diphtheria, pertussis and tetanus vaccination, within the framework of which it can therefore be administered, thus making possible a wide application. However, the 12-15 year-old age group should also be involved in the vaccination program, for this is the group on the threshold of the periods of greatest danger of infection, which begins with the initiation of first sexual relationships.     

Hepatitis B vaccination coverage of Vietnamese children in south-western Sydney

Vaccination coverage since the selective hepatitis B vaccination of neonates of high-risk group program introduced in 1987, was measured in 658 children from 301 Vietnamese families living in the south-western Sydney. The vaccination rate of children born after the introduction of the program was twice that of children born before its implementation (OR = 2.00, 95% CI 1.65-2.42). The shorter the mother's duration of residency in Australia, the more likely her children were to be fully vaccinated (OR = 2.49, 95% CI 2.43-2.62). A catch-up vaccination program of older siblings is required to assist the public health strategy to reduce the morbidity and mortality from hepatitis B viral infection.     

Hepatitis B and C virus infections in Turkish children with haemophilia

We examined 41 Turkish children with haemophilia for evidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections using the enzyme-linked immunosorbent assay (ELISA). Hepatitis B surface antigen was found to be positive in 11 patients (26.8%) and HCV-specific antibody (anti-HCV) was detected in 10 (24.4%) patients. There was a close relationship of the number of transfusions of blood plasma to the presence of HCV specific antibody, but not to the serum markers of HBV infection. In countries where HBV infection is commonly seen and problems in transfusion practice continue, as in Turkey, children with haemophilia are at greater risk for HBV and HCV infections.     

Hepatitis C in children after transfusion: assessment by look-back studies

A woman presented during two pregnancies (at 25 and 23 weeks' gestation, respectively) because the fetuses had rapid, irregular tachycardia and hydrops. After maternal drug treatment and achievement of slower fetal heart rates, the hydrops gradually resolved. Both babies were born full term with continuing atrial fibrillation. In the first, an ectopic atrial rhythm was temporarily achieved during high dose flecainide treatment but, in the younger sibling, all medications and repeated cardioversions failed even temporarily to convert the atrial fibrillation with an almost isoelectric baseline in ECG to sinus rhythm. Good rate control has been achieved with digoxin in both patients. No infective, immunological, or structural cause was found in either case, and thus an inherited aetiology is probable.     

Hepatitis C viral infection in thalassemic children: clinical and molecular studies

The cells that express Steel factor (SLF) in the gastrointestinal (GI) tract were studied using SLF-lacZ transgenic mice. Expression, detected by beta-galactosidase histochemistry, was evident in cells between the circular and longitudinal muscle layers in the GI tract. Double staining with antibodies specific for the neural markers, PGP 9.5, MAP2 and c-Ret, showed that SLF-lacZ positive cells were enteric neurons. Enteroglia did not express SLF-lacZ. The distribution of expressing cells was complimentary to the expression of c-Kit in myenteric interstitial cells.     

Hepatitis B and C virus infections in children with congenital coagulation disorders

The prevalence of hepatitis B and C virus infections, transmitted by blood transfusions, was studied in 79 children with congenital coagulation disorders. Twenty nine percent had evidences of hepatitis B virus infection and 52% evidences of hepatitis C virus infection. Older children and those with the higher number of transfusions had the highest rates of infections. It is concluded that children with congenital coagulation disorders constitute a high risk group for hepatitis B and C virus infections.     

Hepatitis C virus in multiple episodes of acute hepatitis in polytransfused thalassaemic children

We investigated the course of distinct episodes of acute non-A, non-B (NANB) hepatitis in three polytransfused thalassaemic children. In each case, the first episode was associated with the appearance of serum hepatitis C virus (HCV) RNA and anti-HCV seroconversion. The second episode was accompanied by the reappearance of HCV viraemia, which in two patients was due to reinfection with a different HCV strain and in the third could be the result of either reactivation of primary infection or reinfection with a new but closely related strain. Thus HCV infection may not induce protective immunity, which has implications for vaccine development.     

Hepatitis C virus E2 protein purified from mammalian cells is frequently recognized by E2-specific antibodies in patient sera

The envelope protein of hepatitis C virus (HCV) is composed of two membrane-associated glycoproteins, E1 and E2. To obtain HCV E2 protein as a secretory form at a high level, we constructed a recombinant chinese hamster ovary (CHO) cell line expressing a C-terminal truncated E2 (E2t) fused to human growth hormone (hGH), CHO/hGHE2t. The hGHE2t fusion protein was purified from the culture supernatant using anti-hGH mAb affinity chromatography at approximately 80% purity. The purified hGHE2t protein appeared to be assembled into oligomers linked by intermolecular disulfide bond(s) when density gradient centrifugation and SDS-polyacrylamide gel electrophoresis were employed. When the purified fusion protein was used for testing its ability to bind to antibodies specific for HCV by enzyme-linked immunosorbent assay, the protein was recognized by antibodies in sera from 90% of HCV-positive patients. Treatment of hGHE2t protein by beta-mercaptoethanol, but not by heat and SDS, significantly reduced its reactivity to the antibodies of patient sera, suggesting that intermolecular and/or intramolecular disulfide bonds are important for its ability to recognize its specific antibody and that the E2 protein contains discontinuous antigenic epitope(s).     

Viral hepatitis A, E and their mix (A+E) in children

Atypical ("pseudosarcomatous"), cutaneous, fibrous histiocytoma is a rare connective tissue tumor arising on the trunk and limbs in young adults. Its histological diagnosis is difficult. We report the case of a 25-year-old woman who presented a nodule on her left leg. Two years after an incomplete excision, she developed a large local recurrence. Additional radiotherapy, after total reexcision was performed. This treatment was successful and no further recurrence occurred. Clinicopathological features of atypical ("pseudosarcomatous"), cutaneous, fibrous histiocytoma are reviewed. Differential diagnoses, including atypical fibroxanthoma, angiomatoid fibrous malignant histiocytoma and aneurysmal fibrous histiocytoma are discussed.     

Hepatitis G virus infection in human immunodeficiency virus type 1-infected mothers and their children

Hepatitis G virus (HGV) RNA and anti-E2 glycoprotein antibody (E2Ab) seroprevalence was studied in 58 human immunodeficiency virus type 1 (HIV-1)-infected mothers (34 injecting drug users [IDUs] and 24 with risky sexual behavior [RSB]) and their children (median age, 5 days; range, 1-27). Twelve women (20.6%) were RNA- and 20 (34.4%) E2Ab-positive. Seroprevalence was similar in the IDU and RSB groups and high in RSB partners of IDU men. Five (41.6%) children of RNA-positive mothers were HGV-infected, at a median age of 5 days (range, 1-27), independent of maternal CD4 T lymphocyte numbers, mode of delivery, and HIV-1 transmission; no other child at risk became RNA-positive subsequently. No HGV-infected child (follow-up, 16 months; range, 12-52) showed increased liver enzyme levels; 3 children cleared RNA and E2Ab-seroconverted after 10-48 months. Thus, in HIV-1-infected women, HGV infection is common and also sexually transmitted, and clearance may be impaired. Mother-to-child transmission is frequent and occurs antenatally; children remain long infected without evident disease.     

Impaired increase of prostaglandin E2 in gastric juice during steroid therapy in children

BACKGROUND: Lightning can cause a number of ocular complications. A case involving a patient who developed a cataract and reversible maculopathy in both eyes after being struck by lightning is reported. METHODS: The patient was evaluated for cataract and macular edema by ophthalmoscopic examination, fluorescein angiography, and potential acuity meter. RESULTS: Maculopathy developed that was characterized initially by a retinal cyst with surrounding edema. Later, the lesions evolved to simulate a full-thickness hole. These lesions subsequently resolved, and the patient's visual acuity improved to 20/20 in each eye after cataract extraction. CONCLUSION: Because the visual prognosis for lightning-induced maculopathy is potentially different than that for full-thickness macular holes, careful retinal examination is essential in the preoperative workup.