medical and biological sciences - Collegium Medicum - Uniwersytet ...

Medical and Biological Sciences, 2008, 22/4, 39-42ORIGINAL ARTICLE / PRACA ORYGINALNANatalia Kruszewska 1,2 , Jan Styczyński 2IMPACT OF MANDATORY VACCINATION PROGRAM AGAINST HBVON EPIDEMIOLOGY OF HBV AND HCV INFECTIONSIN CHILDREN WITH MALIGNANCIESZNACZENIE SZCZEPIENIA PRZECIWKO HBV W EPIDEMIOLOGII ZAKAŻEŃ HBV I HCVU DZIECI Z CHOROBAMI NOWOTWOROWYMI1 Students’ Scientific Society, , Nicolaus Copernicus University Collegium Medicum in Bydgoszcz2 Chair and Clinic of Pediatric Hematology and Oncology, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz,Head: Mariusz Wysocki, MD, PhD, professor of medicineSummaryIntroduction. Children with malignancy are athigh risk of hepatitis B and C infections, often with unfavorablecourse of the disease. Before a mandatory vaccinationprogram against HBV was introduced in Poland, HBV andHCV infections were found, respectively, in 62,2% and54,3% of children during anti-cancer therapy. Currently, theoccurrence of hepatitis in Poland is estimated to be 1-1,5%for HBV and 1,5% for HCV.Aims. The purpose of this study was to analyze epidemiologyof HBV and HCV infections among children withmalignancy, with respect to mandatory vaccination programagainst HBV in neonates and infants, which was introducedin 1995.Patients and methods. The study included 305children with malignant diseases, hospitalized between 2004-2008 in the Clinic of Pediatric Hematology and Oncology.146 patients out of 305 (48%) were born prior to 1995. Allpatients were screened for serological markers of HBV andHCV infections during hospitalizations. An infection withHBV was diagnosed when a presence of HBsAg or anti-HBc-IgM antibodies was detected. HCV infection was diagnosedwhen the anti-HCV tests were positive.R e s u l t s . Among 305 patients, 3 were found to beHBV positive (0,98%). All these infections were observedyet at the time of the first admission to the clinic. The patientswere born prior to 1995. Among children undergoingmandatory vaccination program, the presence of anti-HBsantibodies was detected in 150/159 (94%) cases. In 72 casesa protective level of the antibodies was observed. HCV infectionsoccurred in 4 cases (1.3%). Out of these, 3 patientswere infected during anticancer treatment. Three out of 4anti-HCV positive patients were born prior to 1995.Conclusions. (1) Introduction of routine vaccinationagainst HBV helped to control HBV infections amongchildren with malignancy. (2) Coinciding reduction of HCVinfections shows the importance of non-specific prophylaxis.(3) Currently, the risk of HBV and HCV infections duringanticancer treatment does not exceed general population risk.StreszczenieWstę p. Dzieci z chorobami nowotworowymi należądo grupy wysokiego ryzyka zakażenia wirusami zapaleniawątroby, a zakażenia HBV i HCV często mają u nich niekorzystnyprzebieg. Przed wprowadzeniem szczepień ochronnychprzeciwko zakażeniom HBV, odsetek zakażeń HBV iHCV wśród dzieci z chorobami nowotworowymi sięgałodpowiednio 62,2% i 54,3%. Obecnie odsetek zakażeń wpopulacji ogólnej w Polsce wynosi odpowiednio 1-1,5%i 1,5%.C e l p r a c y . Analiza epidemiologiczna zakażeń HBVi HCV u dzieci z chorobami nowotworowymi, z uwzględnieniemwprowadzenia obowiązkowego szczepienia przeciwkoHBV w 1995 roku.Pacjenci i metodyka. Badaną grupę stanowiło305 dzieci z chorobami nowotworowymi, leczonymi w latach