首页|Clinical Predictors of Functional Cure in Children 1–6 Years-old with Chronic Hepatitis B

Clinical Predictors of Functional Cure in Children 1–6 Years-old with Chronic Hepatitis B

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Background and Aims: Hepatitis B surface antigen (HB-sAg) clearance is significantly more common in children with chronic hepatitis B (CHB) than in adults; however, the pos-sible influencing factors related to HBsAg loss have yet to be found. This study aimed to explore the efficacy of long-term interferon (IFN)α therapy in treating children with CHB and analyzed the factors influencing functional cure after treat-ment. Methods: A total of 236 children aged 1–6 years and diagnosed with CHB via liver biopsy were included in the study, all receiving IFNα treatment (IFNα-2b monotherapy, IFNα-2b followed by lamivudine [LAM] or IFNα-2b combined with LAM) and followed up for 144 weeks. A comprehen-sive analysis was conducted on clinical data, including bio-chemical items, serum markers of hepatitis B virus (HBV) and immunological indexes, and logistic regression analysis was used to screen the influencing factors related to HB-sAg loss. Results: The cumulative loss rates of HBsAg were 79.5％, 62.1％ and 42.1％ at 144 weeks after the start of treatment in the 1–3 years-old group, 3–5 years-old group and 5–7 years-old group, respectively (p<0.05). IFNα-2b combined with LAM treatment displayed the highest HBsAg loss rates compared with monotherapy and sequential treat-ment (p=0.011). Younger baseline age and lower HBsAg lev-els were independent factors for the prediction of HBsAg loss (p<0.05). The baseline PreS1 and hepatitis B core antibody levels in the HBsAg loss group were lower than those in the HBsAg non-loss group. In addition, the PreS1 level was posi-tively corelated with the level of HBsAg, HBV DNA and liver inflammation. Conclusions: Long-term treatment with IFNα was effective in achieving HBsAg loss in CHB children aged 1–6 years-old. Age less than 3 years-old and lower HBsAg levels are independent predictors of functional cure in chil-dren with CHB.

Chronic hepatitis BChildreninterferon, IFNTherapeutic efficacyLymphocytesPredictors

Jing Pan、Haiyan Wang、Tiantian Yao、Xuejiao Liao、Hao Cheng、Suthat Liangpunsakul、Yan Wang、Min Zhang、Zheng Zhang

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Department of Infectious Disease,Peking University First Hospital,Beijing,China

Liver Disease Department of The Fifth Medical Center of the General Hospital of PLA,Beijing,China

Institute for Hepatology,National Clinical Research Center for Infectious Disease,Shenzhen Third People's Hospital,The Second Affiliated Hospital,School of Medicine,Southern Uni-versity of Science and Technology,Shenzhen,Guangdong,China

Division of Gastroenterology and Hepatology,Depart-ment of Medicine,Department of Biochemistry and Molecular Biology,Indiana University,Indianapolis,IN,USA

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National Science and Technology Major Project of the Infectious DiseasesShenzhen Sci-ence and Technology Innovation Committee

2018ZX10301404JCYJ20190809160213289

2022

10.14218/JCTH.2021.00142

临床与转化肝病杂志(英文版)

临床与转化肝病杂志(英文版)

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年,卷(期)：2022.10(3)
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