[Analysis of antiviral efficacy in pediatric patients with HBeAg-negative chronic hepatitis B]

Objective: To analyze the antiviral efficacy and its influencing factors in pediatric patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). Methods: Thirty-eight initially treated pediatric patients with HBeAg-negative CHB who visited the Department of Hepatology of the Fifth Medical Center of the General Hospital of the People's Liberation Army (PLA) from June 2010 to June 2019 were retrospectively enrolled, and the clinical medications included interferon alpha (IFN-α) and nucleos(t)ide analogs (NAs). The antiviral efficacy and safety profile were assessed at 96 weeks. Pediatric patients were categorized into a cure group [quantitative HBsAg (qHBsAg)<0.05 IU/mL], a low HBsAg group (0.05 IU/mL≤qHBsAg ≤ 1 500.00 IU/mL), and a high HBsAg group (qHBsAg>1 500.00 IU/ mL) according to different levels of hepatitis B surface antigen (HBsAg). The antiviral efficacy and its influencing factors were analyzed using the Kaplan-Meier method and generalized estimating equations in pediatric patients. Results: Clinical cure was achieved in 13% (5/38) at 96 weeks in pediatric patients. Young age at baseline and high B-lymphocyte count levels were the characteristics of pediatric patients who achieved clinical cure. Further analysis indicated that the HBsAg-negative conversion rate was significantly higher in children aged 1-<3 years than that in children aged 3-<7 and 7-12 years [33% (4/12), 5% (1/20), and 0 (0/6) in the three groups, respectively, P=0.025]. No serious adverse reactions were observed during treatment and follow-up. Conclusion: Antiviral therapy efficacy and safety profile are superior for HBeAg-negative CHB children, and some children can achieve clinical cure.Younger age at baseline and higher B-lymphocyte count level might be important factors favoring the clinical cure in children.