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儿童时期获得的慢性乙型肝炎的长期演变。

The long-term evolution of chronic hepatitis B acquired in childhood.

机构信息

1st Medical Clinic, str. Clinicilor Nr. 3-5, 400006 Cluj-Napoca, Romania.

出版信息

J Gastrointestin Liver Dis. 2009 Dec;18(4):433-8.

Abstract

UNLABELLED

The AIM of this study was to assess the long-term evolution of chronic hepatitis B acquired in childhood.

METHODS

The study was carried out in 2007 - 2008 on a group of 77 adult patients who were diagnosed with chronic hepatitis B in childhood. The actual assessment included epidemiological, clinical, biological and virological data, ultrasound examination in all patients and liver histology in 3 patients.

RESULTS

From the 77 patients, 69 were HBeAg positive and the other 8 patients were anti-HBe positive when the diagnosis was made in their childhood. Thirty-seven patients from the HBeAg positive group and 2 patients from the anti-HBe group had been treated in childhood with IFN-alpha and the other 38 patients remained untreated (32 patients with HBeAg positive and 6 patients anti-HBe positive). Overall, 78.26% seroconverted to anti-HBe (87.50% untreated and 70.27% of patients treated with IFN). After a median follow-up period of 13 years, 36 patients from the HBeAg positive group (48.65% of treated patients and 56.25% of untreated ones) became inactive carriers. Seroconversion to anti-HBs, in the HBeAg positive group, occurred in 10.14% of cases (8.1% in treated patients) without statistical significance. Three patients from the whole group developed cirrhosis but none developed hepatocellular carcinoma.

CONCLUSION

The long-term outcome in our patients with CHB acquired in childhood did not differ between treated and untreated patients.

摘要

目的

本研究旨在评估儿童时期获得的慢性乙型肝炎的长期演变。

方法

该研究于 2007-2008 年在一组 77 名成年患者中进行,这些患者在儿童时期被诊断为慢性乙型肝炎。实际评估包括流行病学、临床、生物学和病毒学数据,所有患者均进行超声检查,3 例患者进行肝组织学检查。

结果

77 例患者中,69 例 HBeAg 阳性,8 例 HBeAg 阳性患者在儿童时期被诊断为抗-HBe 阳性。HBeAg 阳性组的 37 例和抗-HBe 组的 2 例患者在儿童时期接受 IFN-α治疗,其余 38 例未治疗(32 例 HBeAg 阳性,6 例抗-HBe 阳性)。总体而言,78.26%的患者血清学转换为抗-HBe(未治疗患者为 87.50%,接受 IFN 治疗的患者为 70.27%)。中位随访 13 年后,HBeAg 阳性组 36 例(治疗组患者的 48.65%和未治疗组患者的 56.25%)成为非活动携带者。HBeAg 阳性组抗-HBs 血清学转换发生在 10.14%的病例中(治疗组患者为 8.1%),无统计学意义。全组 3 例患者发展为肝硬化,但均未发展为肝细胞癌。

结论

在儿童时期获得 CHB 的患者中,治疗与未治疗患者的长期结局无差异。

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