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. 2022 Jun 28;10(3):405-411.
doi: 10.14218/JCTH.2021.00142. Epub 2022 Jan 4.

Clinical Predictors of Functional Cure in Children 1-6 Years-old with Chronic Hepatitis B

Jing Pan  1   2 , Haiyan Wang  3 , Tiantian Yao  1 , Xuejiao Liao  3 , Hao Cheng  1 , Suthat Liangpunsakul  4 , Yan Wang  1 , Min Zhang  2 , Zheng Zhang  3
Affiliations

Clinical Predictors of Functional Cure in Children 1-6 Years-old with Chronic Hepatitis B

Jing Pan et al. J Clin Transl Hepatol. .

Abstract

Background and aims: Hepatitis B surface antigen (HBsAg) clearance is significantly more common in children with chronic hepatitis B (CHB) than in adults; however, the possible influencing factors related to HBsAg loss have yet to be found. This study aimed to explore the efficacy of long-term interferon (IFN)α therapy in treating children with CHB and analyzed the factors influencing functional cure after treatment.

Methods: A total of 236 children aged 1-6 years and diagnosed with CHB via liver biopsy were included in the study, all receiving IFNα treatment (IFNα-2b monotherapy, IFNα-2b followed by lamivudine [LAM] or IFNα-2b combined with LAM) and followed up for 144 weeks. A comprehensive analysis was conducted on clinical data, including biochemical items, serum markers of hepatitis B virus (HBV) and immunological indexes, and logistic regression analysis was used to screen the influencing factors related to HBsAg loss.

Results: The cumulative loss rates of HBsAg were 79.5%, 62.1% and 42.1% at 144 weeks after the start of treatment in the 1-3 years-old group, 3-5 years-old group and 5-7 years-old group, respectively (p<0.05). IFNα-2b combined with LAM treatment displayed the highest HBsAg loss rates compared with monotherapy and sequential treatment (p=0.011). Younger baseline age and lower HBsAg levels were independent factors for the prediction of HBsAg loss (p<0.05). The baseline PreS1 and hepatitis B core antibody levels in the HBsAg loss group were lower than those in the HBsAg non-loss group. In addition, the PreS1 level was positively corelated with the level of HBsAg, HBV DNA and liver inflammation.

Conclusions: Long-term treatment with IFNα was effective in achieving HBsAg loss in CHB children aged 1-6 years-old. Age less than 3 years-old and lower HBsAg levels are independent predictors of functional cure in children with CHB.

Keywords: Children; Chronic hepatitis B; Lymphocytes; Predictors; Therapeutic efficacy; interferon, IFN.

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Conflict of interest statement

The authors have no conflict of interests related to this publication.

Figures

Fig. 1
Fig. 1. HBsAg loss rate in CHB children undergoing 144-week antiviral treatment.
(A) The proportion of HBeAg seroconversion in HBeAg+ CHB children. (B) The proportion of HBsAg loss in HBeAg+ children (black) vs. HBeAg- children (gray). (C) HBsAg loss rates among different treatment regimens after 144 weeks of treatment. HBsAg, Hepatitis B surface Antigen; CHB, chronic hepatitis B; HBeAg, Hepatitis B e Antigen.
Fig. 2
Fig. 2. Cumulative proportion of HBsAg loss in CHB children with different ages during the 144-week follow-up period.
(A) The cumulative proportions of HBsAg loss in 160 children. (B)The cumulative proportions of HBsAg loss in HBeAg+ children. (C) The cumulative proportions of HBsAg loss in HBeAg- children. The data were calculated by Kaplan-Meier test. HBsAg, Hepatitis B surface Antigen; CHB, chronic hepatitis B; HBeAg, Hepatitis B e Antigen.
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