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Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection
11:14

Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection

Published on: November 7, 2018

Chronic hepatitis type B in childhood: longitudinal study of 35 cases

F Bortolotti, P Cadrobbi, C Crivellaro

    Gut
    |June 1, 1981
    PubMed

    Insights

    Hepatitis B virus infection in children often shows no symptoms but leads to chronic liver disease. Spontaneous remission is possible in chronic active hepatitis, questioning the effectiveness of immunosuppressive therapy.

    Area of Science:

    • Pediatric Hepatology
    • Virology
    • Immunology

    Background:

    • Hepatitis B virus (HBV) infection is a significant global health concern, particularly in children.
    • Chronic HBV infection, indicated by persistent hepatitis B surface antigen (HBsAg) carriage, can lead to long-term liver damage.
    • Understanding the clinical, virological, and histological spectrum of HBV infection in pediatric populations is crucial for effective management.

    Purpose of the Study:

    • To investigate the clinical course and outcomes of chronic hepatitis B virus infection in children.
    • To evaluate the efficacy of immunosuppressive therapy versus spontaneous remission in pediatric chronic active hepatitis.
    • To assess the relationship between viral replication and histological findings in children with chronic HBV.

    Main Methods:

    • Retrospective analysis of 35 children (1-11 years) with HBsAg carriage for at least six months.
    • Clinical assessment, virological markers (HBsAg), and liver biopsy for histological evaluation (chronic persistent and active hepatitis).
    • Long-term follow-up (1-8 years) including monitoring of transaminase levels, viral replication, and treatment outcomes.

    Main Results:

    • Most children were asymptomatic, yet all exhibited hepatic involvement with chronic persistent (18 cases) or chronic active hepatitis (16 cases), including two with cirrhosis.
    • Active viral replication was common in both chronic persistent and chronic active hepatitis.
    • While five patients with chronic persistent hepatitis normalized transaminases, only one cleared HBsAg. Immunosuppressive therapy in chronic active hepatitis yielded limited success (1/11 remission), whereas two untreated patients achieved spontaneous remission.

    Conclusions:

    • Chronic hepatitis B virus infection in children can present asymptomatically but often leads to significant liver pathology.
    • Spontaneous remission of chronic active hepatitis is possible in children, suggesting a potential for self-resolution.
    • The effectiveness of immunosuppressive therapy for chronic active hepatitis in children is questionable, warranting further investigation into alternative management strategies.

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