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Clinical Predictors of Functional Cure in Children 1-6 Years-old with Chronic Hepatitis B
Jing Pan1,2, Haiyan Wang3, Tiantian Yao1
1Department of Infectious Disease, Peking University First Hospital, Beijing, China.
Insights
Long-term interferon (IFN)α therapy effectively clears Hepatitis B surface antigen (HBsAg) in children with chronic hepatitis B (CHB). Younger age and lower HBsAg levels predict successful functional cure.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Hepatitis B surface antigen (HBsAg) clearance is more frequent in children than adults with chronic hepatitis B (CHB).
- Factors influencing HBsAg loss in pediatric CHB remain largely unidentified.
- Interferon (IFN)α therapy is a potential treatment for pediatric CHB.
Purpose of the Study:
- To evaluate the efficacy of long-term IFNα therapy in children with CHB.
- To identify factors associated with HBsAg loss and functional cure in pediatric CHB patients.
Main Methods:
- 236 children (aged 1-6 years) with CHB received IFNα treatment (monotherapy, sequential, or combination with lamivudine [LAM]).
- Follow-up duration was 144 weeks, with comprehensive analysis of clinical, biochemical, virological, and immunological data.
- Logistic regression analysis identified factors predicting HBsAg loss.
Main Results:
- Cumulative HBsAg loss rates at 144 weeks were 79.5% (1-3 yrs), 62.1% (3-5 yrs), and 42.1% (5-7 yrs) (p<0.05).
- IFNα combined with LAM showed higher HBsAg loss rates than monotherapy or sequential treatment (p=0.011).
- Younger age (<3 years) and lower baseline HBsAg levels were independent predictors of HBsAg loss (p<0.05).
Conclusions:
- Long-term IFNα therapy is effective for achieving HBsAg loss in children aged 1-6 years with CHB.
- Age under 3 years and lower baseline HBsAg levels are significant predictors of functional cure in pediatric CHB.
Background And Aims:
Hepatitis B surface antigen (HBsAg) clearance is significantly more common in children with chronic hepatitis B (CHB) than in adults; however, the possible influencing factors related to HBsAg loss have yet to be found. This study aimed to explore the efficacy of long-term interferon (IFN)α therapy in treating children with CHB and analyzed the factors influencing functional cure after treatment.
Methods:
A total of 236 children aged 1-6 years and diagnosed with CHB via liver biopsy were included in the study, all receiving IFNα treatment (IFNα-2b monotherapy, IFNα-2b followed by lamivudine [LAM] or IFNα-2b combined with LAM) and followed up for 144 weeks. A comprehensive analysis was conducted on clinical data, including biochemical items, serum markers of hepatitis B virus (HBV) and immunological indexes, and logistic regression analysis was used to screen the influencing factors related to HBsAg loss.
Results:
The cumulative loss rates of HBsAg were 79.5%, 62.1% and 42.1% at 144 weeks after the start of treatment in the 1-3 years-old group, 3-5 years-old group and 5-7 years-old group, respectively (p<0.05). IFNα-2b combined with LAM treatment displayed the highest HBsAg loss rates compared with monotherapy and sequential treatment (p=0.011). Younger baseline age and lower HBsAg levels were independent factors for the prediction of HBsAg loss (p<0.05). The baseline PreS1 and hepatitis B core antibody levels in the HBsAg loss group were lower than those in the HBsAg non-loss group. In addition, the PreS1 level was positively corelated with the level of HBsAg, HBV DNA and liver inflammation.
Conclusions:
Long-term treatment with IFNα was effective in achieving HBsAg loss in CHB children aged 1-6 years-old. Age less than 3 years-old and lower HBsAg levels are independent predictors of functional cure in children with CHB.
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