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Factors affecting clearance of hepatitis B e antigen in hepatitis B surface antigen carrier children
1Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Hepatitis B e antigen (HBeAg) clearance in children increases with age. Maternal HBsAg status and seeking medical care significantly impact HBeAg clearance rates in chronic hepatitis B virus infection.
Area of Science:
- Pediatrics
- Hepatology
- Virology
Background:
- Chronic hepatitis B virus (HBV) infection is a global health concern, particularly in children.
- Hepatitis B e antigen (HBeAg) seroconversion is a key indicator of viral clearance and a favorable prognosis.
Purpose of the Study:
- To investigate factors influencing the natural history of chronic hepatitis B virus infection in children.
- To determine the rate and predictors of hepatitis B e antigen (HBeAg) clearance in pediatric HBV carriers.
Main Methods:
- Prospective follow-up of 169 asymptomatic HBeAg-positive children.
- Comparison with 59 symptomatic/abnormal liver function carrier children.
- Analysis of age, maternal HBsAg status, and recruitment source as potential factors.
Main Results:
- Annual HBeAg clearance rate was <2% in children under 3 years, increasing with age.
- Children >6 years with HBsAg-positive mothers had lower clearance (14.3%) vs. HBsAg-negative mothers (35.3%).
- Children seeking medical care showed higher clearance (42.4%) than screened children (14.6%).
Conclusions:
- Age, maternal HBsAg status, and recruitment source (clinical vs. screening) are significant predictors of HBeAg clearance in pediatric HBV carriers.
- HBeAg clearance is often associated with immune-mediated viral control and potential liver damage.
- Understanding these factors aids in managing chronic hepatitis B in children.
Abstract:
To understand the natural history of chronic hepatitis B virus infection in children, we studied factors affecting the clearance of hepatitis B e antigen (HBeAg). One hundred sixty-nine apparently healthy children whose sera were positive for HBeAg and hepatitis B surface antigen (HBsAg) and who were recruited by screening were followed prospectively to delineate the HBeAg clearance rate. Another 59 carrier children visiting the outpatient clinic because of symptoms or abnormal liver function were studied for comparison. The annual HBeAg clearance rate was low (less than 2%) during the first 3 years of life but increased with age. The HBeAg clearance rate in children older than 6 years of age was lower in those whose mothers had HBsAg positivity (14.3%) than in those whose mothers had no detectable HBsAg (35.3%). Children who were brought for medical care had higher HBeAg clearance rates (42.4%) than those who were recruited by screening (14.6%) because immune clearance of hepatitis B virus and hence HBeAg often led to hepatocellular damage manifested by abnormal liver function profiles or by symptoms that had caused the parents to seek medical care for their children. We conclude that age, source of subject recruitment, and maternal HBsAg status are important factors affecting HBeAg clearance rate in HBsAg carriers.