HOUSTON –
Hundreds of children affected by chronic or
asymptomatic Hepatitis B may be improperly accounted for and remain unreported
by the Centers for Disease Control (CDC) year after year. Physicians from
the Texas Children’s Hepatitis Clinic begin to address this problem with
a study to estimate the true incidence and distribution of Hepatitis B virus
(HBV) in children living in Houston.
“Hepatitis B virus is a devastating
global healthcare problem and Houston has one of the largest at-risk communities
in the nation,” said Dr. Daniel Leung, Director of the Texas
Children’s Viral Hepatitis Clinic. “This project aims to
better define the true burden of HBV in children and identify the risk factors
for the pediatric HBV cases in Houston”.
To best conduct
this study and most accurately report the HBV pediatric cases in Houston, Texas
Children’s Hospital asks for the participation of local physicians to
provide data.
Data gathered from this retrospective chart
review will be used to educate the community, physicians, schools, families,
and patients about the burden of illness, risks for HBV, and its
prevention.
The Problem
Worldwide, 400 million people live with chronic
HBV with one-third having acquired the disease as children. Up to 95 percent of
infants are acutely infected as a neonate and 80 percent of children less than
five years old are asymptomatic, yet will develop chronic infection.
Unfortunately, only “acute” or
symptomatic cases are reportable by the CDC, leaving hundreds to thousands of
chronic and asymptomatic cases of pediatric HBV unreported and thus untreated.
Without treatment, one quarter of these
children will eventually develop cirrhosis, liver failure, or hepatocellular
carcinoma. Vertical and horizontal transmissions continue to be active problems
due to inadequate or unavailable screening or prophylaxis and continuous
immigration from areas of endemicity.
The lack of HBV awareness in the public
consciousness has resulted in the reduction of HBV’s visibility below
other less prevalent communicable diseases, thus resulting in lack of federal
funding for research and educational programs.
While HBV affects a population seven-fold greater than those
infected with HIV/AIDS and tuberculosis combined, the amount of federal funding
by the CDC to support viral hepatitis programs and research for both Hepatitis
B and C is 1/45th that of HIV and TB. Current
federal funding for Hepatitis B and C is $18.3 million compared to $692 million
for HIV and $144 million for TB.
Houston is a prime location for this study being the fourth
largest city in the US and having one of the largest at-risk immigrant
communities in the nation, including the third largest Vietnamese community.
The Project
This study aims to estimate the true incidence and
distribution of HBV among children (ages 0-17) in Houston, Texas and the
Greater Houston area. The data will identify specific racial,
demographic, environmental, and socioeconomic features that are potential risk
factors for the acquisition of HBV in children and may determine the magnitude
and determinants of underreporting of HBV.
Dr. Leung is working closely with the City of Houston and
Texas Department of State Health on gathering pediatric data. “By
comparing passively reported city data and surveillance of pediatric HBV cases
within the Houston-wide Texas Children’s network over a ten-year period, the
project seeks to understand potential gaps in reporting and identify how to
improve reporting,” said Leung.
If you are a care provider and interested in participating
in this study or require a patient consultation, please contact Dr. Daniel
Leung at tcpahepatitis@texaschildrens.org.
For information about the Texas
Children’s Viral Hepatitis Clinic visit: http://www.texaschildrens.org/carecenters/liver/ViralHepatitisClinic.aspx
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