[Treatment and outcome of chronic hepatitis B in children]

225 children at the age from 6 months to 15 years with chronic hepatitis type B (CHB) were under observation. In addition to clinical biochemical evaluation and morphological recording, there also was the serologic monitoring of the pathologic process condition by means of determination of hepatitis type B and other hepatitis viruses markers. The patients were observed during 1-10 years. It was found that almost all of the patients, with the exception of 3 children (1.3%), had no acute onset of the disease. According to the morphological study data, changes in the liver varied from minimal to apparent activity, up to the formation of hepatocirrhosis in single cases. The clinical presentation of CHB in children included mainly the enlargement and induration of the liver, enlargement of the spleen and anhepatic signs (capillaritis and telangiectasia). After 4 years from the onset of CHB stable and prolonged remission was formed in most of the patients (64.6%); in 35.4% of cases clinical biochemical activity of the disease remained for a longer period of time (5-10 years or longer). The gradual cessation of the disease activity correlates with seroconversion of HBeAg on anti-Hbe. Children with the continuous pathologic process in the liver have HBV DNA in their blood. The main outcome of CHB in children is a prolonged remission with permanent HBs-antigenemia in 89% of cases. The recovery was recorded in 9.68% of cases (disappearance of HbsAg and acquisition of anti-HBs). Hepatocirrhosis was formed in 3 children (1.32%).