To investigate the prevalence and clinical features of hepatitis D virus
infection (HDV) in childhood, total antibody to
hepatitis D antigen (anti-HD) in serum samples from 247 children (29 with acute
hepatitis B, 68 with
chronic hepatitis B, and 150 with asymptomatic
hepatitis B surface antigen (
HBsAg) carriers with normal liver function profiles) were studied using solid-phase competitive radioimmunoassay. Anti-HD was detected in three of the 29 children with acute
hepatitis B and in only one of the 68 with
chronic hepatitis B; none of the serum specimens from 150 asymptomatic carriers with normal liver function profile showed detectable anti-HD. All three children with HDV
coinfection cleared
HBsAg and seroconverted to anti-HBs, whereas one with
superinfection finally had normal liver function without clearance of
HBsAg. To identify possible sources of HDV
infection, HBV markers and anti-HD in family members were also examined. One 4-month-old infant boy became infected through a
blood transfusion from his
hepatitis B e antigen (
HBeAg)-positive carrier father, who had anti-HD. A 4-month-old infant girl was infected through close contact with her
HBeAg-negative carrier father, who had HDV
superinfection. The
infection sources remained undefined in another two patients. The mothers of these four children were seronegative for anti-HD, indicating that perinatal transmission is not the usual mode of HDV
infection in Taiwan. The natural course of either acute or chronic HBV
infections in childhood in Taiwan may be more closely related to HBV itself, or to some other yet unrecognized factor, rather than to HDV
infection.