Chronic hepatitis B in children in Gothenburg, Sweden

Sweden is a low prevalence area for hepatitis B, but the number of chronic: carriers has increased during the last decade due to immigration. Out of a total of 120 children with identified chronic hepatitis B in Gothenburg, S weden, 93 were investigated during the 2-year period 1994-95. The children had a mean age of 10.9 years and originated from 21 different countries. Mo st infections were discovered during various screening programmes after arr ival in Sweden, A total of 90 of the 93 children were HBV-DNA positive by A mplicor HBV Monitor (Roche Diagnostics) and 58% (54/93) were HBeAg positive . All children either originated from areas with a high or medium prevalenc e of HBV infection (81/93, 87%) or mere born in Sweden to mothers originati ng from high or medium prevalence countries (12/93, 13%). Three of these 12 children were vertically infected in spite of adequate immunoprophylaxis a nd 8 were born to mothers with undiscovered chronic HBV infection. In all, 34 children had mothers who were HBsAg positive. No overt case of transmiss ion was notified in day-care centres or schools, or from a child to a non-i mmune parent. None of the children reported any symptoms of liver disease, but 38% (35/93) had elevated aminotransferases. Therefore, screening progra mmes are essential to identify chronic HBV infection in children in order t o prevent transmission and to find individuals at risk of progressive liver damage who should be considered for treatment.