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**A large outbreak of hepatitis A occurred in Michigan , and sporadic cases in neighbour states. Authors demonstrated by genetic sequencing that hepatitis A cases from the outbreak had identical viral RNA sequences, as well as hepatitis A cases in other states which could therefore be related to the Michigan outbreak. Hepatitis A was associated with consumption of frozen strawberries from the same processor, served in schools . Strawberries had been contaminated before freezing, possibly during harvest.
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**A randomised controlled trial of hepatitis A vaccine in 146 households of sporadic hepatitis A cases. Secondary cases occurred in 2.8% of households from the vaccinated group, versus 13.3% from the unvaccinated group. One secondary infection was prevented for 18 individuals vaccinated.
7. Zimmerman RK, Mieczkowski TA: How important is early childhood hepatitis B vaccination ? A survey of primary care physicians. The Journal of Family Practice 1998;47:370-374
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**Surveillance data analysis showing a progression of the incidence of hepatocellular carcinoma in the US from 1.4 per 100000 (1976-1980) to 2.4 per 100000 (1991-1995), with a shift to younger people. Hepatitis B and C are the putative risk factors. This rising incidence could be related to the cohort of people infected by hepatitis B and C virus in the 1960s and 1970s true needle sharing, intravenous drug use, contaminated blood products.
15. Ikeda K, Saitoh S, Suzuki Y, Kobayashi M, Tsubota A, Koida I, Arase Y, Fukuda M, Chayama K, Murashima N, Kumuda H: Disease progression and hepatocellular carcinogenesis in patients with chronic viral hepatitis: a prospective observation of 2215 patients. J Hepatol 1998;28:930-938
*Prospective evaluation of 2215 patients with viral hepatitis. The median observation period was 4.1 years and chronic hepatitis B developed to cirrhosis in 10.2% of 610 adult patients. The cumulative progression rate to cirrhosis reached 21% after 10years and 37% after 15 years, while the amount of alcohol intake was shown to be an independent factor of progression to cirrhosis
16. Wong JB: Interferon treatment for chronic hepatitis B: costs and effectiveness. Acta Gastroenterol Belg 1998;61:238-242
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*185 mediterranean children were followed for an average of 13 years, some of them treated. The majority had postnatal contamination. 84% cleared HBe ag on follow up but only 6 % lost HBs ag. Hepatitis relapse was observed after HBe ag loss in 9 patients, some of them being infected with HBe minus precore mutants. Two patients developed hepatocellular carcinoma .
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19. Omata M: Treatment of chronic hepatitis B infection. The New England Journal of Medecine 1998;339:114-115
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** The largest ever published randomised controlled trial of interferon for the treatment of chronic hepatitis B in children. Interferon, given at a dose of 6 megaunits, 3times per week, for 6 months, was able to promote HBe ag and HBs ag loss in 26% of treated patients versus 11% of untreated patients at one year. At 18 months, 33% ot treated patient had lost HBe ag. This was accompanied by normalization of transaminases and improvement of histology. HBs ag loss was achieved in ten percent of treated versus 1% of untreated children.
21. Lai CL, Chine RN, Leung NWY, Chang TT, Guan R, Tai DI, Ng KY, Wu PC, Dent JC, Barber J, Stephenson SL, Gray DF: A one year trial of lamivudine for chronic hepatitis B. N Eng J Med 1998;339:61-68
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24. Lu SN, Chen HC, Tang CM, Wu MH, Yu ML, Lu CF, Chang WY, Chen CJ: Prevalence and manifestations of hepatitis C seropositivity in children in an endemic area. Pediatr Infect Dis 1998;17:142-145
25. Resti M, Azzari C, Mannelli F, Moriondo M, Novembre E, de Martino M, Vierucci A: Mother to child transmission of hepatitis C virus: prospective study of risk factors and timing of infection in children born to women seronegative for HIV-1. BMJ 1998;317:437-440
**The study includes a large number of mother-infant pairs which allows statistical analysis of variables associated with transmission, with the exclusion of HIV coinfection
26. Kumar RM, Shahul S: Role of breast-feeding in transmission of hepatitis C virus to infants of HIV-infected mothers. J Hepatol 1998;29:191-197
27. Wejstal R, Widell A, Norkrans G: HCV-RNA levels increase during pregnancy in women with chronic hepatitis C. Scan J Infect Dis 1998;30:111-113
*Shows that HCV RNA levels increase at the end of pregnancy thus possibly favoring transmission
28. Mazza C, Ravaggi A, Rodella A, Padula D, Muse M, Lomini M, Puoti M, Rossini A, Cariani E: Prospective study of mother-to-infant transmission of hepatitis C virus (HCV) infection. Study Group of Vertical Transmission. J Med Virol 1998;54:12-19
29. Papaevangelou V, Pollack H, Rochford G, Kokka R, Hou Z, Chernoff D, Hanna B, Krazinski K, Borkowsky W: Increased transmission of vertical hepatitis C virus (HCV) infection to human immunodeficiency virus (HIV) - infected infants of HIV- and HCV-coinfected women. J Infect Dis 1998;178:104-152
30. Bortolotti F, Resti M, Giacchino R, Crivellaro C, Zancan L, Azzari C, Gussetti N, Tasso L, Faggion S: Changing epidemiologic pattern of chronic hepatitis C virus infection in Italien children. J Pediatr 1998;133:378-381
*Shows that, after the disappearance of posttransfusion hepatitis, vertical transmission is the main route of HCV spread in childhood
31. AnonymousHepatitis C virus infection. American Academy of Pediatrics. Committee on Infectious Diseases. Pediatrics 1998;101:48-485
32. Davison SM, Skidmore SJ, Collingham KE, Irving WL, Hubscher SG, Kelly DE: Chronic hepatitis in children after liver transplantation: role of hepatitis C virus and hepatitis G virus infections. J Hepatol 1998;764-770
33. Mc Diarmid SV, Conrad A, Ament ME, Vargas J, Martin MG, Goss JA, Busuttil RW: De novo hepatitis C in children after liver transplantation. Transplantation 1998;66:311-318
**analyzes prevalence and outcome of de novo HCV infection also in relation to interferon treatment
34. Thomas SL, Newel ML, Peckham CS, Ades AE, Hall AJ: A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol 1998;27:108-117
35. Ebeling F: Epidemiology of the hepatitis C virus. Vox sg 1998;74:143-146
36. Bernard O: Mother-to-infant transmission of hepatitis C. Acta Gastroenterol Belgica 1998;61:192-194
37. Jonas MM, Ott MJ, Nelson S, Badizadegan K, Perez-Atayde A: Interferon-alpha treatment of chronic hepatitis C virus infection in children. Ped Infect Dis J 1998;17:241-246
38. Vegnente A, Iorio R, Pensati P: Treatment of pediatric hepatitis C: results and perspectives. Acta Gastroenterol Belgica 1998;61:235-236
39. Sawada A, Tajiri H, Kozaiwa K, Guo W, Tada K, Etani Y, Okada S, Sako M: Favorable response to lymphoblastoid interferon alpha in children with chronic hepatitis C. J Hepatol 1998;28:184-188
40. Al-Tawil Y, Nelson C: Interferon treatment of children with chronic hepatitis C. Hepatogastroenterology 1998;345:541-548
41. McHutchison JG, Gordon SC, Schiff ER, Shiffman ML, Lee WM, Rustgl VK, Goodman ZD, Ling MH, Cort S, Albrecht J: Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. The New England Journal of Medecine 1998;339:1485-1492
** provides clear data on a large series of naive patients treated for comparison with monotherapy and combination
42. Davis GL, Esteban-Mur R, Rustgi V, Hoefs J, Gordon SC, Trepo C, Shiffman ML, Zeuzem S, Craxi A, Ling MH, Albrecht J: Interferon alfa-2b alone or in combination with ribavirin for the treatment of relapse of chronic hepatitis C. The New England Journal of Medecine 1998;339:1493-1499
**Large study demonstrating that combination treatment is superior to interferon monotherapy in the retreatment of relapsers
43. Roth WK, Weber M, Seifried E: Feasibility and efficacy of routine PCR screening of blood donations for hepatitis C virus, hepatitis B virus, and HIV-1 in a blood-bank setting. Lancet 1999;353:359-363