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 inregard 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.
Medical Director and Founder of Adoptiondoctors.com
and Adoptioneducationclasses.com
Disclaimer
The information and advice provided is intended to be
general information, NOT as advice on how to deal with a particular child's
situation and or problem. If your child has a specific problem you need to ask
your pediatrician about it - only after a careful history and physical exam can
a
medical diagnosis and/or treatment plan be made. This Web
site does not constitute a physician-patient relationship.