Pediatr Gastroenterol Hepatol Nutr.  2014 Mar;17(1):41-46.

The Rate of Conversion from Immune-tolerant Phase to Early Immune-clearance Phase in Children with Chronic Hepatitis B Virus Infection

• Hong SJ
• Park HJ
• Chu MA
• Choi BS
• Choe BH

Abstract

PURPOSE
The spontaneous seroconversion rate of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) virus infection in children is lower than that in adults. However, few studies have investigated the rate of transition from the immune-tolerant to the early immune-clearance phase in children.
METHODS
From February 2000 to August 2011, we enrolled 133 children aged <18 years who had visited the Department of Pediatrics, Kyungpook National University Hospital. All subjects were in the immune-tolerant phase of HBeAg-positive CHB virus infection. The estimated transition rate into the early immune-clearance phase was calculated using the Kaplan-Meier method.
RESULTS
Among the 133 enrolled pediatric CHB virus infection patients in the HBeAg-positive immune-tolerant phase, only 21 children (15.8%) had converted to the early immune-clearance phase. The average age at entry into active hepatitis was 10.6+/-4.8 years. The incidence of transition from the immune-tolerant to the early immune-clearance phase in these children was 1.7 episodes/100 patient-years. When analyzed by age, the estimated transition rate was 4.6%, 7.1%, and 28.0% for patients aged <6, 6-12, >12 years, respectively.
CONCLUSION
In children with CHB virus infection, the estimated rate of entry into the early immune-clearance phase was 28.0% for patients aged 12-18 years, which was significantly higher than that observed for children aged <12 years (11.7%; p=0.001).

Keyword

Child; Hepatitis B virus; Chronic hepatitis B; Phase transition; Natural history

MeSH Terms

Adult
Child*
Gyeongsangbuk-do
Hepatitis
Hepatitis B
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Incidence
Natural History
Pediatrics
Phase Transition

Figure

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  Fig. 1 Cumulative proportion of children transitioning from the immune-tolerant phase to the early immune-clearance phase analyzed using the Kaplan-Meier method (n=133).

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  Fig. 2 Transition rate from the immune-tolerant phase to the early immune-clearance phase according to the patient age.

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