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Chronic Hepatitis B In Children: Case Series From A Tertiary Paediatric Hospital
Fazilcan Zirek1, Ferda Ozbay Hosnut2, Gulseren Sahin2
1Pediatric Pulmonology, Ankara Universitesi Tip Fakultesi, Ankara, Turkey.
Insights
Chronic hepatitis B in children is a significant health issue. Spontaneous seroconversion occurred in some pediatric patients, but clear treatment guidelines are needed.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Virology
Background:
- Chronic hepatitis B (CHB) is a global health concern, particularly in children.
- Seroconversion is linked to better long-term outcomes in CHB patients.
- Current treatment strategies for pediatric CHB lack consensus regarding timing and duration.
Purpose of the Study:
- To evaluate the clinical course of CHB in children.
- To identify characteristics of pediatric patients achieving spontaneous seroconversion.
- To compare the efficacy of different CHB treatment modalities in children.
Main Methods:
- Retrospective study of 114 pediatric patients (aged 1-18 years) diagnosed with CHB.
- Evaluation of spontaneous hepatitis B envelope antigen (HBeAg) and surface antigen (HBsAg) seroconversion.
- Comparison of treatment regimens in a subgroup of 31 treated patients.
Main Results:
- Spontaneous HBeAg seroconversion occurred in 20.6% and HBsAg seroconversion in 1.8% of eligible pediatric patients.
- Patients with HBeAg seroconversion had a longer follow-up period.
- Treated patients presented with statistically higher serum alanine aminotransferase (ALT) levels at diagnosis.
Conclusions:
- Hepatitis B virus (HBV) infection and CHB remain a significant pediatric health problem.
- Establishing a consensus on the appropriate upper limit of normal (ULN) for ALT is crucial for guiding hepatitis treatment in children.
Background:
Chronic hepatitis B (CHB) remains an important global public health problem. Seroconversion is highly correlated with favourable long-term outcome. There is no consensus on the treatment method, onset time and duration for paediatric CHB patients. In this study, we aimed to evaluate the course of children with CHB, to determine the characteristics of the patients who developed spontaneous seroconversion and treatment indications, and to compare the effectiveness of different treatment modalities.
Patients And Methods:
Patients aged 1-18 years with a diagnosis of CHB were included in this study and evaluated for the development of spontaneous hepatitis B envelope antigen (HBeAg)/surface antigen (HBsAg) seroconversion and treatment modalities. The treated patients were divided into two groups according to their treatment regimen.
Results:
Of the 114 patients, the median age at diagnosis was 8.4 years and median follow-up period was 5.2 years. Spontaneous HBeAg and HBsAg seroconversion developed in 18 (20.6%) of 87 HBeAg positive patients and two (1.8%) patients, respectively. Thirty-one patients were treated. The follow-up period was higher in the group with HBeAg seroconversion (p:0.005). There was no statistical difference between the patients in terms of seroconversion development and treatment status. The serum alanine aminotransferase (ALT) values at the time of diagnosis were statistically higher in treated patients.
Conclusion:
HBV infection and CHB continue to be an important problem for children in our country. Consensus on the appropriate ALT ULN is needed for the treatment of hepatitis in children.
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