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Universal Hepatitis B Vaccination Reduces Childhood Hepatitis B Virus–Associated Membranous Nephropathy
Pediatrics, 09/09/2011
Liao MT et al. – These results revealed a significant decrease in the frequency of hepatitis B virus (HBV)–associated membranous nephropathy (HBVMN) in children with nephrotic syndrome (NS) and in long–term follow–up HBsAg carriers. Children with HBVMN are primarily infected with HBV via horizontal transmission; thus, the significant reduction in horizontal transmission in HBsAg–carrier children in the general population after universal HBV vaccination may explain the reduction of HBVMN in the vaccinated population.
Methods- This study included 471 hospitalized children with nephrotic syndrome (NS) and 488 long-term follow-up hepatitis B surface antigen (HBsAg)-carrier children.
- Horizontal transmission (negative maternal HBsAg status) of HBVMN and HBV was assessed, and the incidence of HBVMN was compared before and after initiation of the universal HBV vaccination program started in 1984.
- The frequency of HBVMN in children with NS was 11.6% between 1974 and 1984, 4.5% between 1984 and 1994, 2.1% between 1994 and 2004, and 0% between 2004 and 2009.
- Similarly, the number of HBsAg-seropositive children with NS (mainly via horizontal infection) decreased after universal vaccination.
- The prevaccination frequency of HBV horizontal transmission in chronic HBsAg carriers from the general population was 36.5% compared with 5% in the postvaccination period.
- The incidence of HBVMN in these carriers revealed a parallel decline.