Paediatric chronic hepatitis B virus infection: are children too tolerant to treat?

• Published in: Acta Paediatrica 2019-06, Vol.108 (6), p.1144-1150
• Main Authors: El‐Raziky, Mona El‐Said, Fouad, Hanan Mina, Abd Elkhalak, Noha Saber, Ghobrial, Carolyne Morcos, El‐Karaksy, Hanaa Mostafa
• Format: Article
• Language: English
• Subjects: Antigens; Children; Chronic hepatitis B; Chronic infection; Guidelines; HB e antigen‐positive chronic hepatitis; Hepatitis; Hepatitis B; Hepatitis B virus; Infections; Interferon; Treatment eligibility; Viruses
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.14626

Aim Guidelines for managing the hepatitis B (HB) virus infection in children are still evolving. We aimed to assess the eligibility of children with HB virus infections for treatment based on the current guidelines. Methods This observational study took place in 2016 and focused on children with isolated chronic HB infections, who attended the paediatric hepatology units at two centres in Egypt. We recruited all treatment‐naïve children aged one year to 18 years who had completed at least 12 months of follow‐up. Results The study comprised 103 children aged between 1.5–18 years. Of these, 51 (50%) had the HB e antigen‐positive chronic infection, 28 (27%) had the HB‐negative chronic infection, 11 (11%) had the HB e antigen‐positive chronic hepatitis and none had the HB e antigen‐negative chronic hepatitis. The remaining 13 (12%) children did not fulfil the criteria for chronic HB definitions. Only two of the children were candidates for treatment: both had HB e antigen‐positive chronic hepatitis and had undergone liver biopsies. Conclusion Only two of the 103 children with chronic HB were eligible for treatment according to the current guidelines and every measure should be taken to prevent the HB virus infection in children.