B alert: hepatitis B virus infection in children in Victoria

Aim: The aim of this study is to determine the demographic, clinical and serological patterns of hepatitis B in children in Victoria over a 17-year period.

Methods: Retrospective analysis of medical records of all patients <18 years of age with positive hepatitis B surface antigen referred to the Gastroenterology, Immigrant Health and Infectious Diseases clinics between 1992 and 2009.

Results: Of the 164 children identified, 76% were born overseas, with vertical transmission the most likely source in 84%. Most were asymptomatic, with no signs of chronic liver disease. Forty children infected with hepatitis B virus (HBV) were born in Australia prior to universal vaccination. There was poor documentation of vaccination or response to vaccination in siblings at risk within families where at least one child was infected. An increasing number of referrals was noted from 2006 to 2009 compared with the preceding 4 years (P < 0.001). Of an expected 200 follow-up visits from new referrals, 78% were attended.

Conclusion: These findings suggest that the number of children with HBV in our population is increasing and that models of health care designed to integrate primary with specialist care are required to minimise the overall health care burden of this chronic infection.