Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study
Abstract
:1. Introduction
2. Materials and Method
- Individuals aged between 0 and 18 years at the time of their first pediatric consultation for chronic HBV infection.
- Detection of hepatitis B surface antigen (HBsAg) persisting for a minimum of six months.
3. Results
3.1. Natural Evolution
3.2. Evolution under Treatment
4. Discussion
4.1. Vertical Transmission
4.2. Clinical Manifestations
4.3. Spontaneous Seroconversion in HBe System
4.4. Antiviral Treatment
4.5. Treatment Side Effects
4.6. Correlations between HBe Seroconversion and Parasitosis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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New EASL Nomenclature | Old Nomenclature | Viral Replication | Risk of HCC | ALT Values |
---|---|---|---|---|
HBeAg+ Chronic HBV Infection | Immunotolerant | High Replicative Phase | Low | Low |
HBeAg+ Chronic Hepatitis B | Immuno-clearance/Active Immune Phase | Moderately Replicative Phase (HBeAg+/-) | Increased | High |
HBeAg- Chronic HBV Infection | Inactive Carrier | Low Replicative Phase | Low | Low |
HBeAg- Chronic Hepatitis HBV | Chronic Hepatitis HBeAg | Moderately Replicative Phase HBeAg- | Increased | High |
Age Group (Years) | HBeAg- Hepatitis | HBeAg+ Hepatitis | HBeAg- Infection | HBeAg+ Infection | Total |
---|---|---|---|---|---|
Pearson Chi-Square = 12,189/p = 0.007 ** | n% | n% | n% | n% | n% |
0–1 year | 2 (18.2%) | 19 (26.0%) | - | 9 (22.0%) | 30 (20.3%) |
2–5 years | 2 (18.2%) | 17 (23.3%) | 8 (34.8%) | 12 (29.3%) | 39 (26.4%) |
6–10 years | 3 (27.3%) | 14 (19.2%) | 6 (26.1%) | 11 (26.8%) | 34 (23.0%) |
11–14 years | 1 (9.1%) | 16 (21.9%) | 6 (26.1%) | 5 (12.2%) | 28 (18.9%) |
15–18 years | 3 (27.3%) | 7 (9.6%) | 3 (13.0%) | 4 (9.8%) | 17 (11.5%) |
Total | 11 (100.0%) | 73 (100.0%) | 23 (100.0%) | 41 (100.0%) | 148 (100.0%) |
Patients related to group (%) | 7.4% | 49.3% | 15.5% | 27.7% | 100% |
Disease Stage at DG | HBeAg+ Infection | HBeAg- Infection | HBeAg+ Hepatitis | HBeAg- Hepatitis | Total |
---|---|---|---|---|---|
Pearson Chi-Square = 12,189/p = 0.007 ** | n% | n% | n% | n% | n% |
Clinical Manifestation NO | 23 (56.1%) | 11 (47.8%) | 18 (24.7%) | 4 (36.4%) | 56 (37.8%) |
Clinical Manifestation YES | 18 (43.9%) | 12 (52.2%) | 55 (75.3%) | 7 (63.6%) | 92 (62.2%) |
Total | 41 (100.0%) | 23 (100.0%) | 73 (100.0%) | 11 (100.0%) | 148 (100.0%) |
Clinical Manifestations | HBeAg+ Infection n, % | HBeAg- Infection n, % | HBeAg+ Hepatitis n, % | HBeAg- Hepatitis n, % | Total n, % | Pearson Chi-Square/p-Value |
---|---|---|---|---|---|---|
Vomiting | - | 2 (8.7%) | 4 (5.5%) | - | 6 (4.1%) | 3.852/0.278 |
Loss of appetite | 2 (4.9%) | 4 (17.4%) | 17 (23.3%) | 1 (9.1%) | 24 (16.2%) | 7.001/0.072 |
Physical weakness | 3 (7.3%) | 1 (4.3%) | 1 (1.4%) | 1 (9.1%) | 6 (4.1%) | 3.197/0.362 |
Semi consistent stools | 1 (2.4%) | 1 (4.3%) | 3 (4.1%) | 1 (9.1%) | 6 (4.1%) | 0.998/0.802 |
Abdominal pain | 3 (7.3%) | 3 (13.0%) | 11 (15.1%) | 2 (18.2%) | 19 (12.8%) | 1.723/0.632 |
Hepatomegaly | 1 (2.4%) | - | 15 (20.5%) | 2 (18.2%) | 18 (12.2%) | 11.991/0.007 ** |
Odynophagia | 1 (2.4%) | - | 6 (8.2%) | 1 (9.1%) | 8 (5.4%) | 3.442/0.328 |
Cough | 1 (2.4%) | 2 (8.7%) | 6 (8.2%) | 1 (9.1%) | 10 (6.8%) | 1.693/0.638 |
Rhinorrhea/pharyngeal congestion | 4 (9.8%) | 1 (4.3%) | 4 (5.5%) | 1 (9.1%) | 10 (6.8%) | 1.081/0.782 |
Epistaxis | 3 (7.3%) | - | 3 (4.1%) | - | 6 (4.1%) | 2.559/0.465 |
Fever | 2 (4.9%) | 1 (4.3%) | 4 (5.5%) | - | 7 (4.7%) | 0.647/0.886 |
Fatigue | 1 (2.4%) | 2 (8.7%) | 2 (2.7%) | - | 5 (3.4%) | 2.579/0.461 |
Others | 5 (12.2%) | 4 (17.4%) | 14 (19.2%) | 3 (27.3%) | 26 (17.6%) | 1.664/0.645 |
Age | n | % |
---|---|---|
5 months | 1 | 1.1 |
1, 2 years | 2 | 2.2 |
2 years | 8 | 9.0 |
3 years | 2 | 2.2 |
5 years | 1 | 1.1 |
6 years | 2 | 2.2 |
7 years | 4 | 4.5 |
8 years | 4 | 4.5 |
9 years | 2 | 2.2 |
10 years | 1 | 1.1 |
11 years | 1 | 1.1 |
12 years | 2 | 2.2 |
13 years | 4 | 4.5 |
14 years | 2 | 2.2 |
15 years | 7 | 7.9 |
16 years | 1 | 1.1 |
HBe Spontaneous Seroconversion | Lamblia Pre- Seroconversion No (n, %) | Lamblia Pre- Seroconversion Yes (n, %) | Lamblia Pre- Seroconversion Unknown (n, %) | Total (n, %) |
---|---|---|---|---|
Pearson Chi-Square = 1.791/p = 0.408 | ||||
NO | 0 (0.0%) | 1 (6.3%) | - | 1 (2.3%) |
YES | 7 (100%) | 15 (93.8%) | 21 (100%) | 43 (97.7%) |
Total | 7 (100%) | 16 (100%) | 21 (100%) | 44 (100%) |
Disease Stage at DG | Antiviral Treatment No (n, %) | Antiviral Treatment Yes (n, %) | Total (n, %) |
---|---|---|---|
Pearson Chi-Square = 9.456/p = 0.024 | |||
HBeAg+ Infection | 29 (32.6%) | 12 (20.3%) | 41 (27.7%) |
HBeAg- Infection | 16 (18.0%) | 7 (11.9%) | 23 (15.5%) |
HBeAg+ Hepatitis | 35 (39.3%) | 38 (64.4%) | 73 (49.3%) |
HBeAg- Hepatitis | 9 (10.1%) | 2 (3.4%) | 11 (7.4%) |
Total | 89 (100%) | 59 (100%) | 148 (100%) |
Antiviral Treatment | n | % |
---|---|---|
Interferon | 20 | 13.5 |
Peginterferon | 10 | 6.8 |
Entecavir | 21 | 14.2 |
Telbivudine | 1 | 0.7 |
Tenofovir | 5 | 3.4 |
Zeffix | 16 | 10.8 |
Side Effects | n | % |
---|---|---|
No | 23 | 39% |
Yes | 36 | 61% |
Total | 59 | 100% |
Clinical Manifestations | n | % |
---|---|---|
Fever | 17 | 28.8 |
Leukopenia | 6 | 10.2 |
Nausea/vomiting | 5 | 8.5 |
Loss of appetite | 4 | 6.8 |
Osteopenia | 4 | 6.8 |
Abdominal pain | 4 | 6.8 |
Chills | 3 | 5.1 |
Headache | 3 | 5.1 |
Neutropenia | 2 | 3.4 |
Hypertriglyceridemia | 2 | 3.4 |
Psychomotor agitation | 2 | 3.4 |
Arthralgia | 2 | 3.4 |
Cardiovascular disorders | 2 | 3.4 |
Epistaxis/gingival bleeding | 1 | 1.7 |
Fracture | 1 | 1.7 |
Hypothyroidism | 1 | 1.7 |
Lymphopenia | 1 | 1.7 |
Myalgia | 2 | 3.4 |
Thrombocytopenia | 1 | 1.7 |
Urticaria | 1 | 1.7 |
Vertigo | 1 | 1.7 |
HBe Seroconversion Post-Treatment | n | % |
---|---|---|
No | 33 | 55.9 |
Yes | 26 | 44.1 |
Total | 59 | 100 |
Treatment | Intron A | PegIFN | Entecavir | Telbivudine | Tenofovir | Zeffix |
---|---|---|---|---|---|---|
HBe seroconversion post-treatment | 50% | 60% | 28.8% | 100% | 20% | 68.8% |
Nr patients | 10 | 6 | 6 | 1 | 1 | 11 |
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Forna, L.; Bozomitu, L.; Lupu, A.; Lupu, V.V.; Cojocariu, C.; Anton, C.; Girleanu, I.; Singeap, A.M.; Muzica, C.M.; Trifan, A. Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study. Biomedicines 2024, 12, 1585. https://doi.org/10.3390/biomedicines12071585
Forna L, Bozomitu L, Lupu A, Lupu VV, Cojocariu C, Anton C, Girleanu I, Singeap AM, Muzica CM, Trifan A. Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study. Biomedicines. 2024; 12(7):1585. https://doi.org/10.3390/biomedicines12071585
Chicago/Turabian StyleForna, Lorenza, Laura Bozomitu, Ancuta Lupu, Vasile Valeriu Lupu, Camelia Cojocariu, Carmen Anton, Irina Girleanu, Ana Maria Singeap, Cristina Maria Muzica, and Anca Trifan. 2024. "Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study" Biomedicines 12, no. 7: 1585. https://doi.org/10.3390/biomedicines12071585
APA StyleForna, L., Bozomitu, L., Lupu, A., Lupu, V. V., Cojocariu, C., Anton, C., Girleanu, I., Singeap, A. M., Muzica, C. M., & Trifan, A. (2024). Insights into the Natural and Treatment Courses of Hepatitis B in Children: A Retrospective Study. Biomedicines, 12(7), 1585. https://doi.org/10.3390/biomedicines12071585