Functional Cure of Chronic Hepatitis B with Antiviral Treatment in Children having High-level Viremia and Normal or Mildly Elevated Serum Aminotransferase  

作　　者：Jing Li Peiyao Fan Zhiqiang Xu Yi Dong Fuchuan Wang Weiguo Hong Jinfang Zhao Yinjie Gao Jianguo Yan Lili Cao Chao Zhang Shishu Zhu Fu-Sheng Wang Min Zhang 

机构地区：[1]Peking University 302 Clinical Medical School,Beijing,China [2]Senior Department of Infectious Diseases,The Fifth Medical Center of Chinese PLA General Hospital,National Clinical Research Center for Infectious Diseases,Beijing,China [3]Senior Department of Liver Diseases,The Fifth Medical Center of Chinese PLA General Hospital,Beijing,China

出　　处：《Journal of Clinical and Translational Hepatology》2023年第5期1011-1022,共12页临床与转化肝病杂志（英文版）

基　　金：supported by Innovation Groups of the National Natural Science Foundation of China(81721002);the China National Natural Science Foundation(82130019);the National Key R&D Program of China(2019YFC0840704).

摘　　要：Background and Aims:There is a lack of data supporting the notion that antiviral treatments can beneft children with chronic hepatitis B(CHB)having high viremia and normal or mildly elevated serum alanine aminotransferase(ALT)levels.We aimed t analyze the efficacy of antiviral treatments in children with CHB and explore the factors associated with functional cure.Methods:Forty-eight children with CHB having high viremia and normal or mildly elevated serum ALT levels were screened in this real-world study.Thirty-two children received either interferon-alpha(IFN-α)monother-apy,IFN-a therapy with a nucleoside analog(NA)add-on,or IFN-α and NA combination therapy.The 16 children in the control group did not receive antiviral treatment.All 48 chil-dren were available for follow-up assessments for the entire 36-month study period.We identified a functional cure with respect to hepatitis B virus(HBV)DNA loss,loss/seroconver-sion of circulating hepatitis B e antigen(HBeAg),and loss of hepatitis B surface antigen(HBsAg)with or without serocon-version.Cox regression analysis was employed to evaluate the factors that may have influenced the functional cure.Re-sults:After 36 months,the cumulative functional cure rate was 56.25%(18/32)in the treated group and 0%(0/16)in the control group(p<0.001).In the treated group,the serum HBV DNA levels declined rapidly at the end of a 6-month visit and the cured children achieved a loss rate of 100%(18/18)within 16 months of beginning treatment,compared with 64.29%(9/14)of the uncured children(p<0.001).The rates of HBeAg seroconversion were significantly higher among the cured children than among the uncured children(p<0.001).All 16 children in the control group maintained high levels of serum HBV DNA and were positive for both serum HBeAg and HBsAg during the entire 36 months of the study period.Func tional cure was associated with younger ages(1-6 vs.7-14 years,p=0.013),CD8^(+)T lymphocyte counts(p=0.013),and B lymphocyte counts(p=0.003).No serious adverse events were observed.Conclu

关 键 词：Child HBV Chronic hepatitis B Antiviral therapy Functional cure 

分 类 号：R512.62[医药卫生—内科学]