Korean J Pediatr Infect Dis.  2004 May;11(1):73-80. 10.14776/kjpid.2004.11.1.73.

Follow-up of Children with Chronic Hepatitis B Virus Infection

• Hwang SH
• Kim JH
• Kang JH
• Hur JK
• Lee KI
• Oh JH
• Lee SH
• Koh DK

• KMID: 2440072
• DOI: http://doi.org/10.14776/kjpid.2004.11.1.73

Abstract

PURPOSE
The serial clinical findings, biochemical results, and serological hepatitis B virus(HBV) markers in Korean children with chronic HBV infection were analyzed to determine the relationships among these factors.
METHODS
Ninety children have been chosen from those who have visited to the Department of Pediatrics at St. Vincent's Hospital in The Catholic University of Korea from July 1st, 1995 to June 30th, 2000. The sample patients were followed up for over six months. HBV markers and liver function tests were all performed.
RESULTS
All children were asymptomatic at presentation. Eighty-three percent of the children had a history of chronic HBV infection in their families. Eighty-one percent were HBeAg positive, 16% were anti-HBe positive, while 3% were all HBeAg and anti-HBe negative. The prevalence of HBeAg among three age groups : 0~5; 6~10; and 11~15 year-old was 90%, 96% and 61% respectively. The prevalence of HBeAg in less than 10 year-old group was significantly higher than 11~15 year-old group(P=0.001). Serum ALT levels were within 40 IU/L in 64% children, 41~80 IU/L in 17%, 81~200 IU/L in 10%, and beyond 201 IU/L in 9%. The percentage of abnormality of ALT levels in HBeAg positive patients was significantly higher than that of HBeAg negative(P=0.036). Eleven of the 73 HBeAg positive children lost their HBeAg and seroconverted to anti-HBe. In these cases, all had transient elevations in ALT levels before HBeAg seroconversions. The annual rates of spontaneous seroconversion of HBeAg and HBsAg were 9.7% and 0.6%, respectively.
CONCLUSION
Recognition of the dynamics of these changes in viral markers and biochemical findings is needed in the selection and evaluation of therapeutic regimens, establishment of treatment, and calling for controlled trials with adequate follow-up. The hepatitis B carrier state may be asymptomatic in children however, continued surveillance of carriers is important to determine the individual adverse prognostic factors of chronic HBV infections.

Keyword

Hepatitis B virus; Children; HBsAg annual seroconversion rate

MeSH Terms

Biomarkers
Carrier State
Child*
Follow-Up Studies*
Hepatitis B
Hepatitis B e Antigens
Hepatitis B Surface Antigens
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Korea
Liver Function Tests
Pediatrics
Prevalence
Seroconversion
Biomarkers
Hepatitis B Surface Antigens
Hepatitis B e Antigens