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KMID : 0816120140170010041
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2014 Volume.17 No. 1 p.41 ~ p.46
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The Rate of Conversion from Immune-tolerant Phase to Early Immune-clearance Phase in Children with Chronic Hepatitis B Virus Infection
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Hong Suk-Jin
Park Hyo-Jung
Chu Mi-Ae
Choi Bong-Seok
Choe Byung-Ho
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Abstract
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Purpose: The spontaneous seroconversion rate of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) virus infection in children is lower than that in adults. However, few studies have investigated the rate of transition from the immune-tolerant to the early immune-clearance phase in children.
Methods: From February 2000 to August 2011, we enrolled 133 children aged ＜18 years who had visited the Department of Pediatrics, Kyungpook National University Hospital. All subjects were in the immune-tolerant phase of HBeAg-positive CHB virus infection. The estimated transition rate into the early immune-clearance phase was calculated using the Kaplan-Meier method.
Results: Among the 133 enrolled pediatric CHB virus infection patients in the HBeAg-positive immune-tolerant phase, only 21 children (15.8%) had converted to the early immune-clearance phase. The average age at entry into active hepatitis was 10.6±4.8 years. The incidence of transition from the immune-tolerant to the early immune-clearance phase in these children was 1.7 episodes/100 patient-years. When analyzed by age, the estimated transition rate was 4.6%, 7.1%, and 28.0% for patients aged ＜6, 6-12, ＞12 years, respectively.
Conclusion: In children with CHB virus infection, the estimated rate of entry into the early immune-clearance phase was 28.0% for patients aged 12-18 years, which was significantly higher than that observed for children aged ＜12 years (11.7%; p=0.001).
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KEYWORD
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Child, Hepatitis B virus, Chronic hepatitis B, Phase transition, Natural history
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