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Chronic hepatitis B in children after e antigen seroclearance: Final report of a 29-year longitudinal study†
Article first published online: 22 FEB 2006
Copyright © 2006 American Association for the Study of Liver Diseases
Volume 43, Issue 3, pages 556–562, March 2006
How to Cite
Bortolotti, F., Guido, M., Bartolacci, S., Cadrobbi, P., Crivellaro, C., Noventa, F., Morsica, G., Moriondo, M. and Gatta, A. (2006), Chronic hepatitis B in children after e antigen seroclearance: Final report of a 29-year longitudinal study. Hepatology, 43: 556–562. doi: 10.1002/hep.21077
Potential conflict of interest: Nothing to report.
- Issue published online: 22 FEB 2006
- Article first published online: 22 FEB 2006
- Manuscript Accepted: 10 DEC 2005
- Manuscript Received: 16 AUG 2005
Chronic hepatitis B is usually a benign disease in Caucasian children; however, the long-term prognosis remains unsettled. This report describes the results of a 29-year longitudinal study including 99 white children with chronic hepatitis B, mainly acquired horizontally: 91 were hepatitis B e antigen (HBeAg) positive (4 had cirrhosis), and 8 were HBeAg negative at presentation. Of the 91 HBeAg-positive children, 89 underwent HBeAg seroconversion after a mean period of 5.2 ± 4.0 years and were included in the study. Of the 85 children without cirrhosis, one had HBeAg-negative hepatitis and the other 84 became inactive carriers. During a mean follow-up of 14.5 ± 6.1 years after HBeAg seroclearance, 4 carriers experienced reactivation, and 3 of them had HBeAg-negative hepatitis at the last follow-up. Of the 8 initially HBeAg-negative children, 2 had HBeAg-negative hepatitis, and 6 were inactive carriers. Of the 4 children with cirrhosis, 2 had hepatocellular carcinoma (HCC) and remained alive and 2 lost the histological features of cirrhosis in adulthood. Two patients with HBeAg-negative hepatitis and 1 with cirrhosis had experienced drug abuse. At the end of follow-up, 15 of the 89 initially HBeAg-positive patients and 2 of 8 initially HBeAg-negative children had cleared hepatitis B surface antigen. In conclusion, the overall prognosis for chronic hepatitis B in horizontally infected Caucasian children is favorable; however, some patients progress to HCC and HBeAg-negative hepatitis. Long-term monitoring is important, as is counseling on cofactors of liver damage, such as alcohol and drug abuse. (HEPATOLOGY 2006;43:556–562.)