CHRONIC HEPATITIS B VIRUS INFECTIONS IN CHILDREN : CLINICAL AND
EPIDEMIOLOGICAL CHARACTERISTICS
Zhu CHM
Children’s
Hospital, Chongqing University of Medical Sciences Chongqing China
Objective: The aim of this study was to investigate the clinical and
epidemiological features of chronic hepatitis B virus infection in
children.
Methods: We retrospectively studied 85 patients (58 males,
27females), aged 2 months-16 years, (mean of 8.74 years).
Results: Of the 85 patients, 65 had probably acquired infection
from a family contact (56mothers, 8father, 1 sibling),1 had a history of
blood transfusions. More than a half of the patients had no evidence of
exposure to HBV in their clinical history, but when family screenings for
HBV markers were performed, a high circulation of HBV markers was found in
the families of such children. A history of hepatitis B vaccination was
recorded in 14 of the 85 patients. Of 85 patients, 78 had chronic
hepatitis, 3 had subfulminanit hepatitis and 4 had liver cirrhosis. Two third
of children with chronic hepatitis B seen in this study were asymptomatic,
although at physical examination many of them were found to have mild to
moderate hepatomegaly and abnormal transaminases. Fourty-three of 55
children were confirmed to have serum HBV-DNA. Mixed infection was due to
HCV and HBV (3.6 percent), HBV and HDV superinfection (10.9 percent).
Conclusions: The result shows the outcome of chronic infection B in children
considerable variation ranging from spontaneous resolution to death though
liver cirrhosis. Majority children with chronic hepatitis B seen in this
study were asymptomatic, and suggests that the frequency of chronic
hepatitis in childhood might be largely underestimated. In fact, majority
of chronic hepatitis B in children had probably acquired infection from a
family contact. The close association between HDV superinfection and
anti-HBe positivity, which is in keeping with the well known inhibitory
effect of HDV on HBV replication. These epidemiological findings enphasise the
role of HBV vaccine in prevention of chronic type B hepatitisof chidren.