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.