Muhammad Almas Hashmi, Aftab Anwar.
Risk factors for viral hepatitis B and C infection in children.
Pak Armed Forces Med J Jan ;68(3):627-33.

Objective: To determine the frequency of different predisposing illnesses and risk factors responsible for spread of chronic viral hepatitis in children. Study Design: Descriptive study. Place and Duration of Study:  Department of Pediatric Gastroenterology, Hepatology, The Children’s Hospital and the Institute of Child Health Lahore, from Jan to Dec 2016. Material and Methods: Patients screened positive for HBV and HCV by HBsAg and Anti HCV were included in the study and further confirmation of infection was done by PCR and/or HBeAg. History regarding various risk factors and pre-existing illnesses was taken and all data was analyzed using SPSS version 20. Results: Total 122 patients, mean age 9.86 ± 3.63 years, 89 male and 33 female; were included. Hepatitis B was found in 31 (25%) while hepatitis-C 91 (75%) patients. HCV genotype 3 was most frequent (69/91, 78%). Common pre-existing illnesses were: acute lymphoblastic leukemia 19 (15.57%), thalassemia 11 (9.02%), non-Hodgkin lymphoma 3 (2.46%), Hodgkin disease 2 (1.64%) and Celiac Disease 3 (2.46%). Hyperbilirubinemia (bilirubin >1.2mg/dL) was found in 15 (12.29%), elevated ALT (>42 iu/mL) in 49 (40.16) patients and ultrasound abnormalities in 21 (17%) patients. Most frequent risk factor was blood component transfusion present in 62 (51%) patients followed by perinatal transmission in 33(26%), history of viral hepatitis in father in 6 (6%) and history of surgery or dental procedure was present in 19 (16%) patients. Conclusion: Hematological malignancies and thalassemia are the commonest predisposing conditions of HBC and HCV infection in children. Most common mode of transmission was blood transfusion present in nearly half the patients followed by perinatal transmission.  

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