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- Title
Screening Abdominal Ultrasounds in Children with Chronic Viral Hepatitis.
- Authors
Bow, Simon; Yap, Jason
- Abstract
INTRODUCTION: Surveillance for hepatocellular carcinoma is recommended in at risk adults with chronic viral hepatitis. The suggested modality is abdominal ultrasound (USS) with or without serum alpha fetoprotein. However, no recommendations exist in children. The choice of modality, frequency and timing are derived empirically or extrapolated from the adult literature. This study aims to assess the utility of screening and surveillance USS in children with chronic viral hepatitis. METHODS: A retrospective chart review of all pediatric patients diagnosed with chronic hepatitis B and C, from 1995 to 2009 (inclusive) was conducted. Inclusion criteria were chronic HBV or HCV infection for at least 6 months and age < 18 years. RESULTS: Forty three children were included into the study; 33 chronic hepatitis B infection (HBV), 9 chronic hepatitis C (HCV), and 1 HBV/HCV co-infection. The mean age at presentation was 9.8 years (95% CI: 7.1-11.2) with an average follow-up of 32 months. Vertical transmission accounted for 53% percent of all cases; whereas only 1 of 10 HCV infections was horizontally acquired. The majority (88%) of HBV cases were immigrants from endemic regions. The median ALT at presentation was 31 (IQR: 21-53). Screening USS were performed on 51% of children, while 79% of children received at least one USS during their care. Seventy two percent of screening USS were normal. Abnormal hepatic echotexture was the most common abnormality identified. Surveillance USS did not identify any hepatic malignancies. Incidental findings were noted in 13% of children during surveillance USS. Although 45% of patients had some findings on screening and surveillance USS, these findings did not influence management. No children received treatment for their chronic viral hepatitis. CONCLUSIONS: In this cohort of children with chronic viral hepatitis, screening and surveillance USS did not significantly alter clinical management. There were inconsistent practices at our institution in requesting USS for children with chronic viral hepatitis.
- Subjects
VIRAL hepatitis in children; ABDOMINAL examination; ABDOMINAL radiography; VIRAL hepatitis; LIVER cancer; JUVENILE diseases; DIAGNOSIS
- Publication
UBC Medical Journal, 2011, Vol 2, Issue 2, p13
- ISSN
1920-7425
- Publication type
Abstract