The obesity epidemic has made fatty liver disease the most common liver disease in childhood, and now these children have a new worry:  A study led by scientists at Cincinnati Children’s shows that most of these children are not protected against the hepatitis B virus even if they have received vaccines.

The study, published online April 17, 2014, in Digestive and Liver Diseases as a letter to the editor, shows that 72 percent of children with fatty liver disease have no immunity against the virus. This leaves them unprotected against secondary damage to the liver that might accelerate scar tissue formation (liver fibrosis) and damage caused by these liver diseases.

“We propose that children with non-alcoholic fatty liver disease undergo comprehensive screening for hepatitis b immunity in addition to screening for infection, says Rohit Kohli, MBBS, MS, a pediatric gastroenterologist at Cincinnati Children’s and the study’s senior author.  “Catch-up or booster vaccinations should also be administered to non-immunized patients, and testing to confirm immunization should be done thereafter.”

Of the children recruited for the study, 200 had no documented hepatitis B antibody.  Of the 104 who did have a documented immunity status, only 29 (28 percent) were found to have positive antibody, indicating immunity.  The remaining 75, (72 percent) were considered non-immune and did not have hepatitis B protection – a surprise given that this vaccine is part of the national vaccination schedule recommended for all children.

Further studies are needed to determine why so many weren’t protected against the virus, Kohli says.