[Rapid progression of hepatocellular carcinoma after surgery: apropos of a case and review of the literature]

We report the case of a young man with chronic hepatitis B infection of probable perinatal acquisition who was diagnosed with hepatocellular carcinoma at a very early stage (BCLC 0) with a highly favorable prognosis. However, the tumor progressed rapidly and the patient died within months. Currently, there are few data that could help to identify cases likely to show rapid progression and which could prompt initiation of aggressive therapies that might prevent or control such progression.

Assessing perinatal hepatitis B screening and neonatal prophylaxis in a large, multiethnic county

OBJECTIVE

To assess the completeness of maternal screening and appropriateness of newborn prophylaxis for hepatitis B virus (HBV) in 2001 in Florida's largest county.

STUDY DESIGN

A retrospective cohort study sampled 1% of deliveries at all hospitals in Miami-Dade County that had delivery suites. Abstractors reviewed mothers' and newborns' charts before discharge to determine whether newborns received appropriate HBV prophylaxis based on mothers' hepatitis B virus surface antigen (HBsAg) status at 12 hours postpartum. At each hospital, deliveries were sampled sequentially until the target number was reached. Sampling was donefor March-August 2001.

RESULTS

Among 339 deliveries at 14 hospitals, the mother's HBsAg status was known within 12 hours of delivery for 286, or 84.4% (95% CI 80.1-88.1%). Of the 53 infants whose mothers' HBsAg status was unknown, 15 (28.3%) were vaccinated within 12 hours of delivery; both infants whose mothers were HBsAg positive received vaccine and immune globulin within 12 hours delivery.

CONCLUSION

While HBsAg screening of pregnant women is widespread in Miami-Dade County, the information is not consistent used to protect infants who mothers' HBsAg status unknown.

Breastfeeding does not pose any additional risk of immunoprophylaxis failure on infants of HBV carrier mothers

Whether babies born to hepatitis B (HB) carrier mothers with HB immunoprophylaxis at birth can be breastfed safely is controversial. A total of 230 such babies were followed up for one year to assess the influence of feeding method on the efficacy of HB immunoprophylaxis. The positive rates of anti-HBs at different ages are not statistically different between the breastfed group and the bottle-fed group. At 1 year, the rate was 80.9% in the breastfed group and 73.2% in the bottle-fed group in infants with HB vaccine alone, and 90.9% in the breastfed group and 90.3% in the bottle-fed group in infants with HBIG plus HB vaccine. There were no significant differences in the incidence of immunoprophylaxis failure between breastfed and bottle-fed babies. The results indicated that breastfeeding does not have a negative influence on the response of anti-HBs and on the failure rates of immunoprophylaxis in the infants born to HB carrier mothers.

Survey of neonatal hepatitis B vaccination in Leicestershire

Some 121,390 live and still births were recorded in Leicestershire between June 1986 and May 1995. All mothers were offered antenatal screening for hepatitis B and 161 were positive for hepatitis B surface antigen. Examination of case notes from 113 mother and baby pairs identified 70 infants who fulfilled criteria for vaccination in place at the time, 47 of whom (67%) had received the three doses of hepatitis B vaccine then recommended for prevention of neonatal infection.

The role of HBV-infection in development of cataracts in children and adults

Possible role of intrauterine HBV infection in the formation of congenital non-hereditary cataracts is testified by discoveries of HBV markers in lens masses, aqueous humor of the anterior chamber and blood serum of the operated children and in blood of mother. We consider the patients with chronic diffuse liver diseases of HBV etiology to be a risk group of post capsular cataracts' formation. The development of these cataracts is associated with the progress of the basic liver disease. Among practically healthy persons, the initial lens changes are more often observed in carriers of australian antigen. Early signs of lens diseases in children and young or middle-aged adults determine the social meaning of this problem and reasons for the regular ophthalmologic check-up of patients with virus liver diseases and somatically healthy virus carriers.