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Functional cure is associated with younger age in children undergoing antiviral treatment for active chronic

Min Zhang1, Jing Li2, Zhiqiang Xu1

  • 1Department of Liver Diseases, National Clinical Research Center for Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.

Hepatology International
|February 20, 2024
PubMed

Insights

Younger children (1-7 years) with chronic hepatitis B (CHB) achieved higher functional cure rates with antiviral therapy compared to older children (≥7 years). Early treatment in pediatric CHB patients is supported by these findings.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Functional cure for chronic hepatitis B (CHB) remains challenging with current antiviral therapies.
  • Limited data exist on treatment outcomes in pediatric populations with CHB.

Purpose of the Study:

  • To assess the frequency of functional cure in children with active CHB undergoing antiviral treatment.
  • To compare treatment outcomes between different age groups of pediatric CHB patients.

Main Methods:

  • Retrospective study of 372 children (aged 1-16 years) with active CHB.
  • Treatment included nucleos(t)ide analog monotherapy or combination therapy with interferon-α (IFN-α) for 24-36 months.
  • Functional cure defined by hepatitis B virus (HBV) DNA loss, HBeAg loss/seroconversion, and HBsAg loss.

Main Results:

  • Children aged 1-7 years showed significantly higher rates of HBV DNA clearance, HBeAg seroconversion, and HBsAg loss compared to those aged ≥7-16 years.
  • Younger children (1-7 years) experienced more rapid reductions in HBV DNA, HBeAg, and HBsAg levels.
  • Lower baseline HBsAg levels (<1,500 IU/mL) were associated with improved cure rates; no serious adverse events were reported.

Conclusions:

  • Children aged 1-7 years with active CHB achieve higher functional cure rates with antiviral therapy than older children.
  • These findings support early antiviral treatment initiation for pediatric CHB.
  • Further prospective randomized controlled trials are needed to validate these results.
Abstract

Keywords:
Antiviral therapyChildChronic hepatitis BFunctional cureHBVHBV DNA lossHBeAg seroconversionHBsAg lossInterferonsNucleoside Analogs

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