Chronic Hepatitis B is usually a benign disease in Caucasian children.
However, the long-term prognosis remains unsettled.
Dr Flavia Bortolotti and colleagues from Italy describe the results of a 29-year longitudinal study.
The study included 99 white children with chronic Hepatitis B.
Of these children, 91 were Hepatitis B e antigen positive, and 8 were Hepatitis B e antigen negative at presentation.
Of the Hepatitis B e antigen positive children, 89 underwent Hepatitis B e antigen seroconversion after a mean period of 5 years, and were included in the analysis.
Of the 85 children without cirrhosis, 1 had Hepatitis B e antigen-negative hepatitis and the other 84 became inactive carriers.
During a mean follow-up of 15 years after seroclearance, 4 carriers experienced reactivation.
The team noted that 3 of them had Hepatitis B e antigen-negative hepatitis at the last follow-up.
|Of the 4 children with cirrhosis, 2 had hepatocellular carcinoma|
Of the 8 initially Hepatitis B e antigen-negative children, 2 had Hepatitis B e antigen-negative Hepatitis, and 6 were inactive carriers.
The team found that of the 4 children with cirrhosis, 2 had hepatocellular carcinoma.
These children survived, and 2 lost the histological features of cirrhosis in adulthood.
The researchers reported that 2 patients with Hepatitis B e antigen-negative Hepatitis, and 1 with cirrhosis had experienced drug abuse.
At the end of follow-up, 15 of the 89 initially Hepatitis B e antigen-positive patients and 2 of 8 initially-negative children had cleared Hepatitis B surface antigen.
Dr Bortolotti's team concluded, “The overall prognosis for chronic Hepatitis B in horizontally infected Caucasian children is favourable.”
“However, some patients progress to hepatocellular carcinoma, and Hepatitis B e antigen-negative Hepatitis."
"Long-term monitoring is important, as is counseling on cofactors of liver damage, such as alcohol and drug abuse."