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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
04:11

Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection

Published on: December 15, 2023

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Chronic Hepatitis Is Common and Often Untreated Among Children with Hepatitis B Infection in the United States and

Simon C Ling1, Hsing-Hua S Lin2, Karen F Murray3

  • 1Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

The Journal of Pediatrics
|May 22, 2021
PubMed

Insights

Chronic hepatitis B virus (HBV) infection in children often shows active hepatitis, but severe outcomes like cirrhosis or cancer are rare. Many children meeting treatment criteria for HBV were not treated.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Virology

Background:

  • Chronic hepatitis B virus (HBV) infection affects children globally.
  • Long-term outcomes in pediatric HBV cohorts in North America are not well-defined.

Purpose of the Study:

  • To determine the clinical outcomes of chronic HBV infection in a large, prospective cohort of children in the US and Canada.
  • To assess the progression and management of pediatric chronic HBV.

Main Methods:

  • Prospective, observational study of 362 children with chronic HBV across 7 clinical centers.
  • Data collected at baseline, 24, 48 weeks, and annually, including demographics, clinical data, and blood tests.
  • Analysis of alanine aminotransferase (ALT) levels, hepatitis B e antigen status, and treatment initiation.

Main Results:

  • Elevated ALT levels were observed in 72% of children at the last evaluation.
  • Significant ALT flares occurred in 13 children.
  • Only 25 out of 129 children meeting treatment criteria initiated anti-HBV therapy.
  • One death (unrelated to liver disease) and one case of cirrhosis were reported; no cirrhotic decompensation or hepatocellular carcinoma observed.

Conclusions:

  • Many children with chronic HBV in the US and Canada exhibit active hepatitis, posing a risk for progressive liver disease.
  • Major adverse liver-related outcomes were infrequent in this cohort.
  • A significant gap exists in treatment initiation for children meeting established criteria for anti-HBV therapy.
Abstract

Keywords:
alanine aminotransferaseclinical outcomesentecavirinterferonlamivudinephenotypeplatelet countvertical transmission

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