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Updated: Nov 15, 2025
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Natural History of Chronic Hepatitis B Infection Among Chinese Children and Young Adults: A Single-Center Experience
Shirley Mo1,2, Loretta Au1, Sherry Huang1
1Charles B. Wang Community Health Center.
Insights
Chronic hepatitis B virus (HBV) infection in Chinese American children commonly presents with immune-tolerant or inactive carrier phases. A significant 38% spontaneous seroconversion rate was observed in this pediatric population.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Viral Hepatitis
Background:
- Limited data exist on the natural history of chronic hepatitis B virus (HBV) infection in Asian American children.
- Understanding HBV infection in this demographic is crucial for effective management and prevention strategies.
Purpose of the Study:
- To describe the clinical characteristics and disease course of chronic HBV infection in Chinese American pediatric patients.
- To analyze the different phases of chronic HBV infection and spontaneous seroconversion rates in this population.
Main Methods:
- Retrospective chart review of pediatric patients with chronic HBV infection from 2006 to 2017.
- Collection and analysis of clinical and laboratory data, including hepatitis B envelope antigen (HBeAg) status and liver enzyme levels.
- Longitudinal follow-up data for patients with at least 5 years of observation.
Main Results:
- Out of 353 patients, 72% were US-born, and 58% tested positive for HBeAg.
- The most common phases were immune-tolerant (34%) and inactive carrier (25%).
- A spontaneous seroconversion rate of 38% was observed among 179 patients followed for ≥5 years.
Conclusions:
- Immune-tolerant and inactive carrier phases are prevalent in pediatric chronic HBV infection among Chinese Americans.
- The study highlights a substantial spontaneous seroconversion rate, indicating potential for viral clearance.
- All US-born patients in the study were born after the implementation of universal HBV immune-prophylaxis.
Objectives:
There are limited data on the natural history of chronic hepatitis B virus (HBV) infection in Asian American children. The aim of the present study was to describe a single-center experience of chronic HBV infection in Chinese American patients in New York City.
Methods:
A retrospective chart review was conducted for patients with chronic HBV infection who had pediatric visits from 2006 to 2017. Clinical and laboratory data were collected to characterize the status of HBV infection and its disease course both cross-sectionally and longitudinally. Available maternal charts were reviewed.
Results:
Of the total 353 patients, 72 patients (20%) were US-born. Positive hepatitis B envelope antigen (HBeAg) was documented in 208 patients (58%). Three phases of chronic HBV infection were categorized for 329 patients: immune-tolerant 112 (34%), HBeAg-positive immune-active 47 (14%), and inactive carrier 82 (25%). The remaining 88 patients (27%) did not fit into a particular category with 26 of 88 patients meeting the criteria for inactive carrier except for mildly elevated alanine aminotransferase. Age and liver enzyme levels were significantly different between HBeAg-positive and HBeAg-negative groups (P < 0.05). Among 179 patients followed for ≥5 years, the spontaneous seroconversion rate was 38%. In eight patients with linked maternal data, all children completed the HBV vaccine series and seven of eight received hepatitis B immunoglobulin. All mothers were HBeAg-positive with high HBV DNA and had no anti-viral therapy during pregnancy.
Conclusions:
Both immune-tolerant and inactive carrier phases were common for chronic HBV infection with a spontaneous seroconversion rate of 38%. All US-born patients were born in the era of implemented universal immune-prophylaxis.
