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Chronic hepatitis B virus infection in children and adolescents in Japan

Haruki Komatsu1, Ayano Inui, Tsuyoshi Sogo

  • 1*Department of Pediatrics, Toho University, Sakura Medical Center, Chiba †Department of Pediatric Hepatology and Gastroenterology, Eastern Yokohama Hospital, Kanagawa, Japan.

Journal of Pediatric Gastroenterology and Nutrition
|September 16, 2014
PubMed

Insights

Hepatitis B e antigen (HBeAg) seroconversion in children with chronic hepatitis B virus (HBV) infection is predicted by higher serum ALT levels. Antiviral treatment accelerates HBeAg seroconversion, a key event in managing chronic HBV.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Chronic hepatitis B virus (HBV) infection requires long-term management.
  • Hepatitis B e antigen (HBeAg) seroconversion is a critical milestone in disease progression.
  • Understanding factors influencing HBeAg seroconversion in children is essential for effective treatment strategies.

Purpose of the Study:

  • To investigate the long-term outcomes of chronic HBV infection in children.
  • To identify factors associated with HBeAg seroconversion in pediatric HBV patients.
  • To evaluate the impact of antiviral treatment on HBeAg seroconversion rates and timing.

Main Methods:

  • Retrospective analysis of 205 children diagnosed with chronic HBV infection before age 20.
  • Evaluation of clinical data including sex, age, HBV genotype, ALT levels, hepatitis flare-ups, and transmission route.
  • Multivariate analysis and Kaplan-Meier survival analysis to determine predictors of HBeAg seroconversion and treatment effects.

Main Results:

  • The maximum serum alanine aminotransferase (ALT) level was the only significant predictor of HBeAg seroconversion (P < 0.05).
  • HBeAg seroconversion was achieved by 49% of the enrolled children.
  • Antiviral treatment was associated with a significantly higher cumulative proportion of HBeAg seroconversion (P = 0.02) and accelerated its achievement (median 10.2 years vs. 12.0 years).

Conclusions:

  • Elevated serum ALT levels are a significant predictor for achieving HBeAg seroconversion in children with chronic HBV.
  • Antiviral therapy can expedite the process of HBeAg seroconversion in pediatric patients with HBV infection.
  • Long-term follow-up and timely treatment are crucial for managing chronic HBV in children.
Abstract

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