Longitudinal Immune Phenotype Assessment and Serological Outcome in Foreign-born Children With Chronic Hepatitis B.
J Pediatr Gastroenterol Nutr
; 71(3): 381-387, 2020 09.
Article
en En
| MEDLINE
| ID: mdl-32826716
ABSTRACT
OBJECTIVES:
The aim of the study was to assess changes in clinical phenotype, and identify determinants of outcome in children with chronic hepatitis B virus (HBV) infection born in HBV-endemic countries followed in 2 Italian tertiary care centers after immigration or adoption.METHODS:
A prospective observational study on hepatitis B e-antibodies-negative chronic hepatitis B children started on 2002. Patients with liver fibrosis, or those needing antiviral treatment were excluded. Immune active patients were defined those with raised transaminases (alanine aminotransferase > 40âIU/L), immune tolerants those having normal alanine aminotransferase, both exhibiting substantial viral replication (HBV DNA >2000âIU/mL).RESULTS:
Sixty-nine patients (44 boys, median age 4.7 years) had a median follow-up of 53 months. At entry, 18 (26%) children were immune tolerant, 47 (68%) immune active, and 4 had indeterminant immune status. At last follow-up, 14 (78%) of the immune-tolerant patients remained so, whereas only 23 (49%) of the immune active children maintained their initial immune phenotype. Seroconversion to hepatitis B e antibodies (SCHBe) occurred in only 2 (11%) immune tolerants, whereas 13 (28%) immune active patients achieved SCHBe.Ethnicity was the only feature independently correlated to SCHBe Asian origin reduced by 4.1 times the probability of SCHBe (Asian vs other; odds ratioâ=â0.24 [95% confidence intervalâ=â0.07-0.76]; Pâ=â0.016) compared to other ethnicities, whereas viral genotype did not influence the outcome.CONCLUSIONS:
Ethnicity and immune status phenotype against HBV, rather than HBV genotype, are the main determinants of SCHBe in foreign-born children with chronic HBV infection.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Hepatitis B Crónica
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Hepatitis B
Tipo de estudio:
Observational_studies
Límite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Año:
2020
Tipo del documento:
Article