Title: Resident synovial macrophages in synovial fluid: implications for immunoregulation in infectious and inflammatory arthritis
Abstract: only following potential exposure.5%-15% of patients may be unable to generate an immune response even after completing two full series of HepB vaccinations, termed non-responders.Additionally, antibody levels may decline to ineffective levels by age 7.Both scenarios significantly increase the risk of HepB development among certain pediatric patients.The CDC states that the Appalachian region has rates of acute HepB higher than the US average.The goal of this project is to evaluate HepB vaccination response in high-risk pediatric patient populations, such as child abuse victims, to develop screening guidelines.Younger children have the highest chance of developing a chronic infection with HepB that can lead to liver damage, failure, and cancer.Effective HepB antibody response to vaccination can prevent lifelong infection.Methods Used: This retrospective chart review aims to investigate factors that contribute to the increased risk of acquiring HepB in pediatric patients.Patients selected were between 0-18 years old.Currently, 131 charts have been reviewed out of 600, and 32 met the criteria of being screened by pediatricians.A HIPAA-compliant REDCap program was used to store and analyze the data.Summary of Results: Preliminary results showed that all patients screened for HepB antigens were negative and not infected when the titer was drawn.Of the patients who were also screened for HepB antibodies,12.5% had levels high enough to prevent infection.50% had negative titer levels, leaving them susceptible, and 37.5% of the individuals lacked a documented HepB titer.This highlights significant potential for improvement in the screening of these patients.The most prevalent risk factors were child abuse in 50% of screened patients, sexual abuse in 54.8%, and a CPS investigation in 56.3% Conclusions: While these results are preliminary, they indicate likely similarities in patients who are being screened and resulting with a negative Hepatitis B antibody titer.Results will serve as a foundation for protocols concerning the management of HepB and educational training for providers working with the pediatric population.