Journal
JOURNAL OF GASTROENTEROLOGY
Volume 52, Issue 9, Pages 1041-1050Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s00535-017-1315-4
Keywords
Chronic hepatitis B; Natural history; Childhood; Mother-to-child transmission; Horizontal transmission
Categories
Funding
- Ministry of Health, Labor and Welfare of Japan
- Japan Agency for Medical Research and Development
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Background It is necessary to evaluate the natural history of children with hepatitis B virus (HBV) infection in each country to consider their long-term management. Methods A multi-center observational study of children with chronic HBV infection who were diagnosed at age <= 15 years was carried out in 18 hospitals in Japan. ResultsWe reviewed children with HBV infection including 381 with mother-to-child transmission (MTCT) and 154 with horizontal transmission, genotype C being the most prevalent virus genotype (83%). Children with horizontal transmission were more frequently infected with HBV genotype A or B and more likely to receive interferon therapy than those infected by MTCT. The HBeAg seroconversion rate at 15 years of age was 42% in the MTCT group and 38% in the horizontal group. It was lower in children with genotype C infection than in those infected with other genotypes (33 versus 45%). Hepatitis developed at any age but before 4 years of age the incidence was high in the horizontal group. At 3 years after the onset of the hepatitis, 26% of children with MTCT and 30% of those with horizontal transmission became inactive carriers. The incidences of hepatocellular carcinoma (HCC) at 30 years of age were 6% in the MTCT group and 11% in the horizontal group. Conclusions Patients with childhood-onset HBV infection with MTCT and horizontal transmission developed hepatitis and seroconverted to anti-HBe at any age and had a lifetime risk of developing HCC.
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