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Klin Padiatr
DOI: 10.1055/a-2135-2000
Original Article

Chronic Hepatitis B In Children: Case Series From A Tertiary Paediatric Hospital

Chronische Hepatitis B im Kindesalter: eine Fallserie aus einer Kinderklinik der Tertiärversorgung
Fazilcan Zirek 
1   Pediatric Pulmonology, Ankara Universitesi Tip Fakultesi, Ankara, Turkey
,
Ferda Ozbay Hosnut
2   Pediatric Gastroenterology, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey
,
Gulseren Sahin
2   Pediatric Gastroenterology, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey
,
Saliha Senel
3   Pediatrics, Dr. Sami Ulus Maternity and Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
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Abstract

Background Chronic hepatitis B (CHB) remains an important global public health problem. Seroconversion is highly correlated with favourable long-term outcome. There is no consensus on the treatment method, onset time and duration for paediatric CHB patients. In this study, we aimed to evaluate the course of children with CHB, to determine the characteristics of the patients who developed spontaneous seroconversion and treatment indications, and to compare the effectiveness of different treatment modalities.

Patients and Methods Patients aged 1–18 years with a diagnosis of CHB were included in this study and evaluated for the development of spontaneous hepatitis B envelope antigen (HBeAg)/surface antigen (HBsAg) seroconversion and treatment modalities. The treated patients were divided into two groups according to their treatment regimen.

Results Of the 114 patients, the median age at diagnosis was 8.4 years and median follow-up period was 5.2 years. Spontaneous HBeAg and HBsAg seroconversion developed in 18 (20.6%) of 87 HBeAg positive patients and two (1.8%) patients, respectively. Thirty-one patients were treated. The follow-up period was higher in the group with HBeAg seroconversion (p:0.005). There was no statistical difference between the patients in terms of seroconversion development and treatment status. The serum alanine aminotransferase (ALT) values at the time of diagnosis were statistically higher in treated patients.

Conclusion HBV infection and CHB continue to be an important problem for children in our country. Consensus on the appropriate ALT ULN is needed for the treatment of hepatitis in children.

Zusammenfassung

Hintergrund Die chronische Hepatitis B (CHB) stellt nach wie vor weltweit ein wichtiges Gesundheitsproblem dar. Die Serokonversion korreliert stark mit einem günstigen Langzeitergebnis. Über die Behandlungsmethode sowie den Zeitpunkt des Beginns und die Dauer der Behandlung von pädiatrischen Patienten mit CHB gehen die Meinungen auseinander. Ziel der vorliegenden Studie war es, den Verlauf bei Kindern mit CHB zu untersuchen, die Merkmale der Patienten, die eine spontane Serokonversion entwickelten, sowie die Behandlungsindikationen zu ermitteln und die Wirksamkeit der verschiedenen Behandlungsmethoden zu vergleichen.

Patienten und Methodik In die Studie, die die Entwicklung einer spontanen Hepatitis-B-Hüllantigen (HBeAg)-/Oberflächenantigen (HBsAg)-Serokonversion sowie die verschiedenen Therapieformen untersuchte, wurden Patienten im Alter von 1-18 Jahren aufgenommen, bei denen die Diagnose CHB gestellt worden war. Die behandelten Patienten wurden nach Therapieregime in zwei Gruppen eingeteilt.

Ergebnisse Bei den 114 Patienten lag das mediane Alter zum Zeitpunkt der Diagnosestellung bei 8,4 Jahren. Die mediane Nachbeobachtungszeit betrug 5,2 Jahre. Eine spontane HBeAg-Serokonversion trat bei 18 (20,6 %) von 87 HBeAg-positiven Patienten und eine spontane HBsAg-Serokonversion bei zwei (1,8 %) Patienten auf. Es wurden 31 Kinder behandelt. Die Nachbeobachtungszeit war in der Gruppe mit HBeAg-Seroconversion (p = 0,005) länger. Hinsichtlich der Entwicklung der Serokonversion und des Behandlungsstatus fanden sich keine statistisch signifikanten Unterschiede zwischen den Patienten. Bei den behandelten Patienten waren die Alanin-Aminotransferase (ALT)-Werte im Serum zum Zeitpunkt der Diagnosestellung statistisch signifikant höher.

Schlussfolgerung HBV-Infektionen und CHB stellen für Kinder in der Türkei nach wie vor ein großes Gesundheitsproblem dar. Für die Behandlung der Hepatitis im Kindesalter ist ein Konsensus über die geeignete obere Normgrenze für ALT-Werte erforderlich.

Keywords

children - chronic hepatitis b - interferon - lamivudine - spontaneous seroconversion

Schlüsselwörter

Kinder - Chronische Hepatitis B - Interferon - Lamivudin - Spontane Serokonversion


Publication History

Article published online:
28 August 2023

© 2023. Thieme. All rights reserved.

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