Abstract
It has been reported recently that the risk of contracting HB infection from chronic red cell transfusion is low if blood is obtained from volunteer donors and screened for HB surface antigen (SAg); immunization with HB vaccine is thus not recommended (J. Ped 1986;108:252). We have reviewed our experience with HB in 24 patients, most with sickle cell disease and cerebrovascular accident. Transfusion duration ranged from 1-15 years (median 7) and donor exposure in 1985 14-49 units (mean 26)/ptn, Patients are transfused with frozen deglycerolized packed cells from volunteer donors screened for HBSAg. Three patients have shown evidence of HB infection. Two sero-con-verted after 2½ and 3 years of transfusion and were asymptomatic. A third patient began regular transfusions in 11/84 at 11 mos. of age due to recurrent acute splenic sequestration. HBSAg was first detected in 2/85 and has persisted through 5/86 despite seroconversion by 4/85, Serum ALT reached a maximum of 1675 U/l in 4/85; the child was and remains clinically well. HB core AB and delta antigen were negative and HBeAg positive in 7/85. While HB infection was clinically mild, it has occurred in 3/24 patients; 1 child has become a chronic carrier of HB with significant social, if not medical, consequences. Additional concerns regarding possible interactions between HB, hemochromatosis, and non-A-non-B hepatitis have led us to immunize all sero-negative patients receiving chronic red cell transfusions.
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Miller, S., Brown, A., Sklar, T. et al. HEPATITIS B (HB) IN CHRONICALLY TRANSFUSED CHILDREN: TO IMMUNIZE OR NOT?. Pediatr Res 21 (Suppl 4), 302 (1987). https://doi.org/10.1203/00006450-198704010-00810
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DOI: https://doi.org/10.1203/00006450-198704010-00810