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Successful treatment of infantile hepatitis B with lamivudine: A case report
Yu-Ting Zhang1, Jing Liu1, Xiao-Ben Pan1
1Department of Infectious Disease, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China.
Insights
Early lamivudine (LAM) treatment for infantile hepatitis B virus (HBV) infection shows promise. This case study suggests LAM is safe and effective for infants, leading to HBV clearance and antibody development.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection in infants presents treatment challenges.
- Lamivudine (LAM), a nucleoside analogue, is approved for children aged 2-17 with chronic hepatitis B.
- The efficacy of LAM in treating infantile HBV infection requires further investigation.
Observation:
- A 4-month-old infant born to an HBsAg-positive mother was diagnosed with HBV infection.
- Initial tests revealed elevated alanine aminotransferase, high levels of HBsAg, HBeAg, and HBV DNA (>1.0 × 10^9 IU/mL).
- The infant received LAM treatment (20 mg/d).
Findings:
- After 19 months of LAM treatment, serum HBsAg was cleared, and hepatitis B surface antibody became detectable.
- The patient completed 2 years of LAM treatment and was followed for 3 years.
- Throughout the follow-up, serum HBV DNA remained undetectable, and hepatitis B surface antibody was persistently positive.
Implications:
- Early LAM treatment may be a safe and effective strategy for managing infantile HBV infection.
- Complete viral clearance and seroconversion (HBsAg loss and anti-HBs gain) are achievable with LAM in infants.
- This case supports the potential of LAM as a therapeutic option for very young children with chronic hepatitis B.
Background:
How to treat infantile hepatitis B virus (HBV) infection remains a controversial issue. The nucleoside analogue lamivudine (LAM) has been approved to treat children (2 to 17 years old) with chronic hepatitis B. Here, we aimed to investigate the benefit of LAM treatment in infantile hepatitis B.
Case Summary:
A 4-mo-old infant born to a hepatitis B surface antigen (HBsAg)-positive woman was found to be infected by HBV during a health checkup. Liver chemistry and HBV seromarker tests showed alanine aminotransferase of 106 U/L, HBsAg of 685.2 cut-off index, hepatitis B "e" antigen of 1454.0 cut-off index, and HBV DNA of > 1.0 × 109 IU/mL. LAM treatment (20 mg/d) was initiated, and after 19 mo, serum HBsAg was entirely cleared and hepatitis B surface antibody was present. The patient received LAM treatment for 2 years in total and has been followed for 3 years. During this period, serum hepatitis B surface antibody has been persistently positive, and serum HBV DNA was undetectable.
Conclusion:
Early treatment of infantile hepatitis B with LAM could be safe and effective.
