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A clinical and immunological study of children with chronic hepatitis B virus infection
Mortada El-Shabrawi1, Manal Abdelgawad2, Ola Elgaddar3
1Paediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
Most children with chronic hepatitis B virus (HBV) infection are asymptomatic and discovered incidentally, often with family history. Treatment reduced HBV DNA but did not clear HBsAg or induce HBsAb seroconversion.
Area of Science:
- Pediatric Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B virus (HBV) infection in children presents unique challenges for management and long-term outcomes.
- Understanding the clinical and immunological status is crucial for assessing short-term consequences.
Purpose of the Study:
- To evaluate the clinical presentation and immunological markers in a cohort of children with chronic HBV infection.
- To assess the short-term impact of antiviral therapy on HBV markers.
Main Methods:
- Prospective case-control study of 30 children (1-15 years) with HBsAg-positive chronic HBV.
- Treatment groups included lamivudine (n=20) and entecavir for lamivudine-resistant cases (n=10).
- Follow-up occurred every 3 months for 1 year.
Main Results:
- 97% of cases were incidentally discovered; 90% had a family history of HBV, predominantly mothers.
- 87% were asymptomatic; 13% had hepatomegaly. Serological profile: 50% HBeAg+, 56.7% HBeAb+, 33.3% HBcAb+, 100% HBsAb-.
- Antiviral treatment significantly decreased HBV DNA levels.
Conclusions:
- Chronic HBV in children is often asymptomatic, incidentally detected, and associated with familial transmission.
- Antiviral therapy reduced viral load but did not lead to HBsAg clearance or HBsAb seroconversion.
- Screening for HBsAb levels in children with family members infected with HBV is recommended.
Aim:
To identify the clinical status and immunological profile of a cohort of children with chronic hepatitis B virus (HBV) infection to assess the short-term consequences of this infection.
Material And Methods:
This prospective case-control study included 30 children in the age range 1-15 years with positive HBsAg attending the Hepatology clinic of Alexandria University Children's Hospital. Twenty children received lamivudine (3 mg/kg, oral, once a day), and 10 children were lamivudine-resistant and received entecavir treatment (10-11 kg/0.3 mg to > 30 kg/1 mg). They were followed up every 3 months for 1 year.
Results:
The study showed that 97% of the studied cases were discovered accidentally during routine investigations and only 3% presented by acute hepatitis. Ninety percent of them had family member infection with HBV, of which 70% were the mother. Eighty-seven percent of cases had no clinical signs, and only 13% of cases had hepatomegaly. All of the cases were HBsAg positive, 50% were HBeAg positive, 56.7% were HBeAb positive, 33.3% were HBcAb positive, and 100% were HBsAb negative.
Conclusions:
Most of children with HBV infection had associated family member infection and were accidentally discovered. Despite a marked decrease in HBV DNA level after treatment, there was no clearance of HBsAg and no HBsAb seroconversion. Screening for the HBsAb level in children with family members with HBV is recommended.
