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Does genotype predict response to treatment in children infected with hepatitis B perinatally?

Elizabeth Boxall1, Jaswant Sira, Shamima Kaskar

  • 1Virology Laboratory, Health Protection Agency, Microbiology Services Division, Heartlands Hospital, Birmingham, United Kingdom. liz@boxall.info

Journal of Medical Virology
|August 30, 2012
PubMed

Insights

Hepatitis B virus (HBV) genotype influences treatment outcomes in children. Genotypes A and D showed better response to antiviral treatments compared to genotypes B and C.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Hepatitis B virus (HBV) infection in children can lead to chronic liver disease.
  • HBV genotype is a known factor influencing disease progression and treatment efficacy.
  • Understanding genotype-specific responses is crucial for optimizing pediatric HBV management.

Purpose of the Study:

  • To investigate the correlation between HBV genotypes and treatment response in children with chronic hepatitis B.
  • To compare the efficacy of different antiviral treatments (interferon, lamivudine, adefovir) based on HBV genotype.

Main Methods:

  • Retrospective analysis of children enrolled in clinical trials since 1990.
  • HBV genotyping performed using direct sequencing or line probe assay (InnoLipa).
  • Treatment response assessed by HBeAg to Anti-HBe seroconversion rates across different genotypes and treatment regimens.

Main Results:

  • Genotype distribution varied by ethnicity: South-Asians predominantly had genotype D, while Europeans and Afro-Caribbeans had genotype A.
  • Children with HBV genotypes A and D exhibited significantly higher seroconversion rates (55.5% and 48.7%) compared to genotypes B and C (12.5% and 0%) across all treatments.
  • Interferon monotherapy showed better response in genotype A than D, but prednisolone priming eliminated this difference.

Conclusions:

  • HBV genotype is a significant predictor of treatment response in children.
  • Genotypes A and D are associated with better outcomes in antiviral therapy for pediatric hepatitis B.
  • Pre-treatment genotyping may guide therapeutic strategies and inform future clinical trial design for pediatric HBV infection.

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