A nine-year experience of immunoprophylaxis against hepatitis B virus infection in children with cancer: results from a single institution in Poland.

The results of a nine-year study of immunoprophylaxis against HBV infection in children with cancer during anticancer therapy are presented. Three hundred and fifty-three children entered the study. The preventive strategy involved three different patterns of passive and active prophylaxis. Specific anti-HBV immunoprophylaxis introduced simultaneously with anticancer therapy resulted in protection of 95.2% of children; 62% of patients produced antibodies. Long-term follow-up confirmed stable protection. Better results were obtained in children who received the last dose of vaccine after chemotherapy. The overall infection rate was 5.4% (19/353). Thirteen (68.4%) of the 19 infections occurred in patients who had not received hepatitis B immunoglobulin at the beginning of anticancer therapy. Children vaccinated before chemotherapy (during a neonatal vaccination programme) showed continuous protection after one dose of vaccine in 94% cases. In three cases, both HBsAg and anti-HBs was observed. A preventive strategy for viral hepatitis in children with cancer that includes passive and active HBV immunoprophylaxis from the beginning of chemotherapy is effective.