Hepatitis B infection in the Institutionalized the child.

My referrals initial Hepatitis B screen was positive at birth, but a follow-up screening test showed a negative result what does this mean?

Hepatitis B is a viral infection of the liver; unfortunately it seems to be endemic in many of the countries that place children up for international adoption.

Modes of transmission:

1) person to person via (needle stick or bites)

2) sexual exposure through bodily secretions

3) mother infant transmission during pregnancy

4) serous fluid from wheeping wounds

The close confines of institutional care seem to increase this risk of transmission.

When adults and older children contract the hepatitis B virus, most fight off the infection relatively effectively. Newborn infants however, due to the immaturity of their immune system are unable to identify this virus as an invader and clear their system of the virus. These children become chronic carriers of the Hepatitis B virus and are at risk for exposing others to the virus as well as possibly developing ongoing liver damage and liver cancer much later in life.

Initial screen for hepatitis B should be performed immediately upon arrival and a second screening test should be done after 12 weeks in order to give time for the virus incubation period to elapse.

Routine tests ordered:

1) Entire Hepatitis B profile, Liver function test

2) All Positive results should be referred to a pediatric gastroenterologist for the evaluation of possible antiviral therapy.

2) Children who have a confirmed negative hepatitis B test should be given the Hepatitis B Vaccine

Now in regard to the question asked by the reader: my referrals initial Hepatitis B screen was positive at birth, but a follow-up screen showed a negative result what does this mean?

This question is hard to answer because we have limited medical information. We do not have access to the entire hepatitis B profile and we do not know which part of the profile was positive. Considering that this was an infant, most positive titers (test results) are usually caused by maternal transfer antibodies through the placenta against a particular virus. Because newborns have a very immature immune system, they are not able to mount their own immune response to the virus that usually happens after 3 months of age. Since the follow-up hepatitis test was negative, (hopefully test was done after the baby was 3 months of age when the baby has its own active immune system) it is my assumption that the newborn is indeed negative to the hepatitis B virus. In other words the baby is not sick with the hepatitis B virus and its body did not create antibodies to the hepatitis B virus.

A translation of all this in more simple terms, the mother was ill with the hepatitis B virus mounted an immune response, which made a positive test screening result in the baby.. When the child was resettled with his own more mature immune system the results were negative, since the baby is not ill with the Hepatitis B virus it did not mount an immune response against the virus.

By George Rogu M.D. Founder of Adoptiondoctors.com and Adoptioneducationclasses.com

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