Paediatric chronic hepatitis B virus infection: are children too tolerant to treat?
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Published on: June 5, 2020
Mona El-Said El-Raziky1, Hanan Mina Fouad2,3, Noha Saber Abd Elkhalak1
1The Department of Paediatrics, Kasr Alainy Medical School, Cairo University, Cairo, Egypt.
Insights
Few children with chronic hepatitis B virus (HBV) infection meet current treatment guidelines. Prevention of HBV infection in children is crucial.
Area of Science:
- Pediatric Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection management in children is evolving.
- Current guidelines for HBV treatment eligibility in pediatric populations require assessment.
Purpose of the Study:
- To evaluate the eligibility of children with chronic HBV infection for antiviral therapy based on existing clinical guidelines.
Main Methods:
- An observational study conducted in 2016 at two Egyptian pediatric hepatology centers.
- Included treatment-naïve children aged 1-18 years with isolated chronic HBV infection and at least 12 months of follow-up.
Main Results:
- 103 children were analyzed; 51% had HBeAg-positive chronic infection, 27% HBeAg-negative chronic infection, and 11% HBeAg-positive chronic hepatitis.
- Only 2 children (1.9%) met criteria for treatment: both had HBeAg-positive chronic hepatitis and underwent liver biopsy.
Conclusions:
- A very low proportion of children with chronic HBV infection are eligible for treatment under current guidelines.
- Emphasizes the critical need for HBV infection prevention strategies in children.
Aim:
Guidelines for managing the hepatitis B (HB) virus infection in children are still evolving. We aimed to assess the eligibility of children with HB virus infections for treatment based on the current guidelines.
Methods:
This observational study took place in 2016 and focused on children with isolated chronic HB infections, who attended the paediatric hepatology units at two centres in Egypt. We recruited all treatment-naïve children aged one year to 18 years who had completed at least 12 months of follow-up.
Results:
The study comprised 103 children aged between 1.5-18 years. Of these, 51 (50%) had the HB e antigen-positive chronic infection, 28 (27%) had the HB-negative chronic infection, 11 (11%) had the HB e antigen-positive chronic hepatitis and none had the HB e antigen-negative chronic hepatitis. The remaining 13 (12%) children did not fulfil the criteria for chronic HB definitions. Only two of the children were candidates for treatment: both had HB e antigen-positive chronic hepatitis and had undergone liver biopsies.
Conclusion:
Only two of the 103 children with chronic HB were eligible for treatment according to the current guidelines and every measure should be taken to prevent the HB virus infection in children.
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