Incidence of acute hepatitis B in patients with spinal cord injury

Abstract

Study design:Retrospective case survey.Objective:To examine incidence and clinical characteristics of hepatitis B infection in individuals with spinal cord injury (SCI).Setting:Inpatient clinic within a physical medicine and rehabilitation hospital specialized in rehabilitation.Participants:A total of 161 patients with SCI.Interventions:Patients records were investigated and the status of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), anti-hepatitis B surface antigen positivity, alanine aminotransferase levels, duration of hospitalization and cost were recorded.Main outcome measures:Incidence of acute hepatitis B.Results:Six patients were diagnosed with acute hepatitis B on the first hospitalization for rehabilitation. A total of 11 patients (4.2%) were HBsAg positive with a previously established diagnosis of hepatitis B virus infection, 1 patient (0.4%) was anti-HCV positive. After a follow-up of 6 months, three of the acute hepatitis B patients progressed into chronic hepatitis B stage. In acute hepatitis B patients initiation of the rehabilitation was delayed, duration of hospitalization was increased. Conclusions:After SCI, patients are at high risk of acute hepatitis B infection. A high rate of chronicity may be associated with impaired immune response, secondary to neurological deficit. Screening and vaccination protocols may prevent the spread of the hepatitis B infection, healthcare losses and financial loss. © 2011 International Spinal Cord Society. All rights reserved.