Related Experiment Video
Updated: Jan 7, 2026
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Clinical, pathological characteristics and long-term outcomes of hepatitis B virus related cirrhosis in pediatric
Bo-Kang Zhao1, Yan Li2, Yi-Yun Jiang2
1Center of Infectious Diseases and Pathogen Biology, Department of Hepatology, The First Hospital of Jilin University, Changchun 130061, Jilin Province, China.
Insights
Pediatric liver cirrhosis (LC) from chronic hepatitis B virus (HBV) infection often shows mild symptoms but progresses rapidly. Early antiviral therapy significantly improves outcomes in children with HBV-related LC.
Area of Science:
- Hepatology
- Virology
- Pediatric Gastroenterology
Background:
- Chronic hepatitis B virus (HBV) infection in childhood can lead to rapid liver cirrhosis (LC) progression before adulthood.
- A subset of pediatric patients with HBV infection develops severe liver disease despite mild initial symptoms.
Purpose of the Study:
- To identify the clinical and pathological characteristics of pediatric HBV-related liver cirrhosis (LC).
- To compare pediatric HBV-related LC with pediatric chronic hepatitis B (CHB) and adult HBV-related LC.
Main Methods:
- A retrospective study of 1332 pediatric patients with chronic HBV infection.
- Identification of 62 pediatric HBV-related LC cases via liver biopsy.
- Comparison with 64 pediatric CHB and 69 adult HBV-related LC cohorts.
Main Results:
- Pediatric LC patients (median age 11) had lower HBV DNA loads and HBsAg titers than pediatric CHB.
- Pediatric LC patients were often asymptomatic (77.4%) with milder initial symptoms than adults.
- Pediatric LC showed significantly better outcomes with antiviral therapy, including higher functional cure rates and remission incidence.
Conclusions:
- Pediatric HBV-related cirrhosis presents with distinct clinical and virological profiles compared to adults.
- Mild initial symptoms in pediatric LC pose diagnostic challenges.
- Early antiviral therapy is crucial for improving clinical outcomes in pediatric HBV-related cirrhosis.
Background:
Chronic hepatitis B virus (HBV) infection acquired in childhood frequently presents with mild or nonspecific symptoms, yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis (LC) before adulthood.
Aim:
To identify clinical and pathological characteristics of pediatric HBV-related LC.
Methods:
A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study. We identified 62 pediatric HBV-related LC by liver biopsy from the group. Subsequently, we described the clinical and pathological characteristics of pediatric LC. And 64 pediatric chronic hepatitis B (CHB; age and sex were matched with pediatric LC group) and 69 adult HBV-related LC (sex were matched with pediatric LC group) were enrolled to further demonstrate clinical and pathological differences between pediatric LC, pediatric CHB and adult LC.
Results:
We enrolled 62 pediatric LC, including 54 (87.1%) males and 8 (12.9%) females. The median age was 11 (4-14) years old. The pediatric LC group showed significantly lower median quantitative HBV DNA loads (log10IU/mL: 6.3 vs 17.4, P < 0.001), reduced HBsAg titers (log10IU/mL: 3.11 vs 8.956, P < 0.0001), and diminished hepatitis B e antigen-positive positive rate (81.4% vs 93.8%, P < 0.05) compared with pediatric CHB. A higher proportion of pediatric patients were asymptomatic (77.4%) compared to adult patients (11.6%) as they first diagnosed as LC, pediatric LC showed milder initial symptoms compared with adult patients such as fatigue (4.8% vs 27.5%), abdominal discomfort (9.7% vs 23.2%), nausea (0% vs 10.1%), and poor appetite (6.5% vs 8.7%; all P < 0.0001). Notably, pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4% and 0%. The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC (hazard ratio = 6.102, 95% confidence interval: 1.72-21.65, P = 0.00051). While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC (hazard ratio = 0.055, 95% confidence interval: 0.07128-0.2802, P < 0.0001).
Conclusion:
Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients. However, the frequent paucity of overt clinical symptoms contributes to diagnostic challenges. Notably, early initiation of antiviral therapy in this population substantially improved clinical outcomes.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion