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Published on: May 10, 2022
Age at treatment initiation predicts response in children with chronic hepatitis B
Xiaoli Wu1, Zhenzhen Yao2, Xin Lai2
1Center for Reproductive Medicine, Maternal and Child Health Hospital of Hunan Province, Changsha, China.
Insights
Starting antiviral treatment for chronic hepatitis B (CHB) earlier in childhood is linked to better outcomes, including higher rates of HBsAg loss and HBeAg clearance.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Age significantly influences hepatitis B virus (HBV) infection outcomes.
- The impact of age on treatment response in pediatric chronic hepatitis B (CHB) requires further elucidation.
Purpose of the Study:
- To investigate the association between age at treatment initiation and clinical outcomes in children with CHB.
- To determine if earlier treatment correlates with improved treatment response in pediatric CHB patients.
Main Methods:
- A cohort of 306 treatment-naïve children with CHB was analyzed.
- Participants were stratified into three age groups at treatment initiation: 1-3, 4-6, and 7-17 years.
- Primary outcome was HBsAg loss; secondary outcomes included HBeAg clearance and HBV DNA undetectability.
Main Results:
- Age at treatment initiation was negatively associated with HBsAg loss and HBeAg clearance.
- Children treated between 1-3 years showed significantly higher rates of HBsAg loss (HR=5.07) and HBeAg clearance (HR=1.73) compared to older groups.
- A linear dose-response relationship was observed between younger age at treatment initiation and improved treatment outcomes.
Conclusions:
- Age at treatment initiation is a significant predictor of treatment response in children with CHB.
- Earlier initiation of antiviral therapy in children with CHB is associated with a higher likelihood of achieving HBsAg loss and HBeAg clearance.
Background:
Accumulating evidence suggests that age has a significant impact on disease progression and outcome of hepatitis B virus (HBV) infection. However, its effect on treatment response has not yet been fully elucidated.
Aim:
To investigate the associations of age at treatment initiation with clinical treatment outcomes in children with chronic hepatitis B (CHB).
Methods:
This study included 306 treatment-naïve children with CHB. Participants were divided into three groups based on the age at which they started antiviral treatment: 1-3 years, 4-6 years and 7-17 years. The primary outcome of this study was HBsAg loss; secondary outcomes included HBeAg clearance and DNA undetectability.
Results:
Of the 306 subjects, 200 (65.4%) were male. Median (IQR) duration of follow-up was 26 (17, 42) months. There were 139 (45.4%), 79 (25.8%) and 88 (28.6%) of participants in the 1-3 years, 4-6 years and 7-17 years groups, respectively. After adjusting for other covariates, age at treatment initiation was negatively associated with the occurrence of HBsAg loss (1-3 years: HR = 5.07, 95% CI = 2.91-8.82; 4-6 years: HR = 2.42, 95% CI = 1.31-4.46) and HBeAg clearance (1-3 years: HR = 1.73, 95% CI = 1.18-2.53). In addition, we observed linear dose-responses relationships between age at treatment initiation and the probability of HBsAg loss and HBeAg clearance.
Conclusions:
In children with CHB receiving antiviral treatment, HBsAg loss and HBeAg clearance were frequently observed. Age at treatment initiation can predict treatment response, including HBsAg loss and HBeAg clearance.
