In Reply.—In our article, we did not intend to address the ethical or social issues of intercountry adoption, although we recognize these do exist and may be severe problems for some families. In fact, questions surrounding the social dilemmas of hepatitis B screening constitute a significant portion of Dr Jenista's infectious disease practice.
We firmly believe, however, that hepatitis B screening should be recommended for Asian immigrant children and probably for all immigrant children from third-world countries, in agreement with recent guidelines published by the Centers for Disease Control, Atlanta.1 Contrary to Dr Campbell's statements, early knowledge of hepatitis B carrier status may provide definite benefits to the child, ie, early detection of chronic persistent or chronic active hepatitis, cirrhosis, and, possibly, primary hepatocellular carcinoma, which has occurred as soon as ten years following hepatitis B infection.2
Knowledge of carrier status allows selective immunization of those households at risk.
JENISTA JA, CHAPMAN D. Ethical Issues in Hepatitis B Screening-Reply. Am J Dis Child. 1988;142(1):13-14. doi:10.1001/archpedi.1988.02150010019008