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Viremia profiles in children with chronic hepatitis B virus infection and spontaneous e antigen seroconversion

Yen-Hsuan Ni1, Mei-Hwei Chang, Pei-Jer Chen

  • 1Department of Pediatrics, Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.

Gastroenterology
|June 16, 2007
PubMed

Insights

Children with chronic hepatitis B (HBV) infection who spontaneously lost hepatitis B e antigen (HBeAg) showed decreased viral loads and normal liver enzymes. Further follow-up is needed to understand the long-term significance of HBeAg seroconversion in childhood.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Chronic hepatitis B virus (HBV) infection is a significant global health concern, particularly in children.
  • Hepatitis B e antigen (HBeAg) seroconversion marks a milestone in chronic HBV infection, often associated with a decline in viral replication.
  • Understanding viremia profiles post-HBeAg seroconversion is crucial for managing pediatric HBV cases.

Purpose of the Study:

  • To investigate the long-term viremia profiles in children with chronic HBV infection following spontaneous HBeAg seroconversion.
  • To analyze factors influencing viremia levels and clinical outcomes after HBeAg seroconversion.
  • To compare viremia patterns between children with low and high viremia post-seroconversion.

Main Methods:

  • A longitudinal study of 58 children with chronic HBV infection who achieved spontaneous HBeAg seroconversion without antiviral treatment.
  • Classification of patients into low viremia and fluctuating high viremia groups based on HBV DNA levels post-seroconversion.
  • Annual assessment of alanine aminotransferase (ALT), HBV DNA levels, and abdominal sonography; analysis of precore mutant and HBV genotypes.

Main Results:

  • Children with spontaneous HBeAg seroconversion experienced a significant decrease in HBV DNA levels from 10(8.4) to 10(2.9) copies/mL.
  • The precore mutant (nt1896) was more prevalent in the fluctuating high viremia group (60.9%) compared to the low viremia group (22.9%).
  • No persistent abnormal ALT levels were observed after HBeAg seroconversion, indicating generally favorable liver health.

Conclusions:

  • Spontaneous HBeAg seroconversion in childhood and young adulthood is generally associated with reduced viral loads and normal liver enzyme levels.
  • The presence of the precore mutant may be linked to higher viremia levels post-seroconversion.
  • Long-term monitoring is essential to fully understand the clinical implications of HBeAg seroconversion in this pediatric cohort.
Abstract

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