Τίτλος:
Natural history of chronic hepatitis B virus infection in children of
different ethnic origins: A cohort study with up to 12 years' follow-up
in northern Greece
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: To investigate the mode of transmission and the natural history of
chronic hepatitis B virus (HBV) infection in children of different
ethnicities in Greece. This study was part of the Interreg I-II EC
project.
Patients and Methods: One hundred seventy-three hepatitis B surface
antigen (HBsAg)(+) carriers, median age 6.9 (5-12) y, were prospectively
followed-up for a mean period of 5.3 (1-12) y for serological markers of
HBV infection, serum alanine aminotransferase (ALT), HBV-DNA,
(x-fetoprotein levels and ultrasonography.
Results: Vertical transmission predominates (61.8%) in Moslem children
and horizontal (44%) in those born in Russia. At entry, 73 of 173
(42%) HBsAg(+) genotype D children were hepatitis B e antigen
(HBeAg)(+), ranging from 27% to 67% among ethnic groups; 55 of 173
(32%) had ALT > 2 x upper normal limit (UNL), ranging from 21% to
39%. Of 100 anti-HBe(+) children, 85 (85%) were inactive carriers.
During the follow-up period, seroconversion to anti-HBe was observed in
40 of 73 (55%) children with an annual rate of 11%; 35 of 40 (87.5%)
had biochemical remission, and 28 of 35 (80%) lost HBV-DNA. In the
anti-HBe(+) group, 27 of 100 (27%) lost HBV-DNA and 9 of 100 (9%) lost
HBsAg. The annual seroconversion rate for HBeAg was significantly lower:
in children with vertical transmission compared with horizontal (7.7%
vs 14.8%, respectively, P < 0.001) and in Muslim children compared with
both Christian children and those born in Russia (8.6% vs 12%,
respectively, P < 0.001). No differences were found among the ethnic
groups after adjusting for the mode of infection. Two of 173 children
had progression of liver disease.
Conclusions: The differences in HBeAg(+) status and seroconversion rate
among the ethnic groups are related to the time/mode of HBV infection.
The majority of children who developed anti-HBe immunity had biochemical
remission, and a substantial number of the inactive carriers lost
viremia during the observation period of up to 12 y.
Συγγραφείς:
Zacharakis, George
Koskinas, John
Kotsiou, Stamatia
Pouliou,
Evaggelia
Papoutselis, Menelaos
Tzara, Fevronia
Vafeiadis,
Nikolaos
Maltezos, Eustratios
Archimandritis, Athanasios and
Papoutselis, Kostantinos
Περιοδικό:
Journal of Pediatric Gastroenterology and Nutrition,
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
HBV infection; children; natural history
DOI:
10.1097/01.mpg.0000243438.47334.07
