Phenotypes of Chronic Hepatitis B in Children From a Large North American Cohort.
J Pediatr Gastroenterol Nutr
; 69(5): 588-594, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31436702
ABSTRACT
OBJECTIVE:
The aim of the study was to define chronic HBV phenotypes in a large, cohort of United States and Canadian children utilizing recently published population-based upper limit of normal alanine aminotransferase levels (ULN ALT), compared with local laboratory ULN; identify relationships with host and viral factors.BACKGROUND:
Chronic hepatitis B virus (HBV) infection has been characterized by phases or phenotypes, possibly associated with prognosis and indications for therapy.METHODS:
Baseline enrollment data of children in the Hepatitis B Research Network were examined. Phenotype definitions were inactive carrier HBeAg-negative with low HBV DNA and normal ALT levels; immune-tolerant HBeAg-positive with high HBV DNA but normal ALT levels; or chronic hepatitis B HBeAg-positive or -negative with high HBV DNA and abnormal ALT levels.RESULTS:
Three hundred seventy-one participants were analyzed of whom 274 were HBeAg-positive (74%). Younger participants were more likely be HBeAg-positive with higher HBV DNA levels. If local laboratory ULN ALT levels were used, 35% were assigned the immune tolerant phenotype, but if updated ULN were applied, only 12% could be so defined, and the remaining 82% would be considered to have chronic hepatitis B. Among HBeAg-negative participants, only 21 (22%) were defined as inactive carriers and 14 (14%) as HBeAg-negative chronic hepatitis B; the majority (61%) had abnormal ALT and low levels of HBV DNA, thus having an indeterminant phenotype. Increasing age was associated with smaller proportions of HBeAg-positive infection.CONCLUSIONS:
Among children with chronic HBV infection living in North America, the immune tolerant phenotype is uncommon and HBeAg positivity decreases with age.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hepatite B Crônica
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Female
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Humans
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Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article