Epidemiology

Favorable prognosis seen in children with chronic hepatitis B

Last Updated: 2007-10-17 16:48:32 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Chronic hepatitis B in children is usually asymptomatic and follows a benign course over the long term, according to a report in the October 15th issue of Clinical Infectious Diseases.

Although chronic hepatitis B generally manifests as mild disease in children and young adults, the authors explain, data regarding its long-term course are scarce.

Dr. Raffaele Iorio and colleagues from University "Federico II," Naples, Italy evaluated the clinical, biochemical, virological, and histological features of chronic hepatitis B virus (HBV) infection in 108 children without concomitant chronic systemic diseases followed for up to 24 years.

During the period of observation, 41 children were treated with interferon-alpha and 67 were untreated.

All patients were asymptomatic at presentation and remained symptom-free during follow-up, apart from adverse effects related to interferon-alpha treatment, the authors report.

None of the children developed evidence of hepatocellular carcinoma. Histological assessment in 57 of the subjects "showed mild-to-moderate disease in 91.2%."

After a median observation period of 12.1 years, Dr. Iorio's team documented clearance of HBeAg and acquisition of anti-HBe in 65.9% of treated patients and 56.7% of the untreated subjects.

They conclude that interferon treatment does not affect the long-term seroconversion rate in patients with chronic HBV acquired in childhood. "These findings should be considered when selecting candidates for treatment and choosing antiviral agents," the investigators suggest.

Clin Infect Dis 2007;45:943-949.