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[Hepatitis B in children in 4 university centers in The Netherlands]
M Nuysink1, P H Rothbarth, C M Bijleveld
1Afd. Nefrologie, Wilhelmina Kinderziekenhuis, Utrecht.
Objective:
To evaluate the prevalence and the natural course of hepatitis B infection in children.
Design:
Retrospective longitudinal.
Setting:
Four university pediatric centres.
Method:
To explore the possibility of starting a trial with interferon alpha, data of viral and biochemical tests and biopsies of children younger than 16 years were studied.
Results:
In a period of 10 years (1980-1990) 145 patients, of whom 74% were not of original Dutch descent, were found positive for HBsAg. The data of 142 patients could be analysed. Seroconversion was seen in 27 patients and 42 were already anti-HBe positive at the time of presentation. Chronic hepatitis, representing the category which could benefit from interferon alpha treatment, was found in 24 patients. Severe complications of the hepatitis were found in 4% of the children, including hepatocellular carcinoma and cirrhosis. Follow-up was insufficient so the seroconversion rate could only be estimated at 12% for the first year following the diagnosis.
Conclusion:
As a result of this study the authors present a proposal for a therapeutic trial with interferon alpha. This is a national protocol under the auspices of the section for pediatric gastroenterology of the Nederlandse Vereniging voor Kindergeneeskunde (Netherlands Pediatric Association).