Chang M H, Hwang L Y, Hsu H C, Lee C Y, Beasley R P
Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Hepatology. 1988 Mar-Apr;8(2):374-7. doi: 10.1002/hep.1840080231.
Liver histologic findings were studied in 18 children who were 4 to 9 years old, and who had been HBsAg carriers since having been infected by their mothers in the perinatal period. All were born to HBeAg-HBsAg carrier mothers; the children were followed periodically from birth. Throughout their entire course, none developed symptoms or signs suggestive of liver disease. All of the 18 children showed mild but definite liver histologic changes: 15 had nonspecific histologic changes, and three had chronic persistent hepatitis. In 13 of 18 children, follow-up aminotransferase activities were abnormal, but none exceeded 100 KU. At the time of biopsy, ALTs on four children were above the upper limit of normal. All children were HBeAg-positive in early infancy, but five lost this antigen and developed antibody during follow-up. The histologic findings in HBeAg-positive children did not differ from those in children with antibody. Perinatal hepatitis B virus infection has been thought to play an important role in chronic liver disease, including hepatocellular carcinoma. This study indicates that some pathologic changes following perinatal infection begin very early.
对18名4至9岁的儿童进行了肝脏组织学检查，这些儿童自围产期被母亲感染后一直是乙肝表面抗原携带者。他们均为乙肝e抗原和乙肝表面抗原携带者母亲所生；这些儿童从出生起就定期接受随访。在整个病程中，没有一个儿童出现提示肝病的症状或体征。所有18名儿童均表现出轻度但明确的肝脏组织学改变：15名有非特异性组织学改变，3名有慢性持续性肝炎。18名儿童中有13名随访时转氨酶活性异常，但均未超过100KU。活检时，4名儿童的谷丙转氨酶高于正常上限。所有儿童在婴儿早期乙肝e抗原均为阳性，但有5名在随访期间失去了该抗原并产生了抗体。乙肝e抗原阳性儿童的组织学表现与有抗体的儿童没有差异。围产期乙型肝炎病毒感染被认为在包括肝细胞癌在内的慢性肝病中起重要作用。这项研究表明，围产期感染后的一些病理变化很早就开始了。
