The Rate of Conversion from Immune-tolerant Phase to Early Immune-clearance Phase in Children with Chronic Hepatitis B Virus Infection
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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DOI：
10.5223/pghn.2014.17.1.41
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发表时间：
2014-03-01
影响因子：
1.9
通讯作者：
Choe, Byung-Ho
中科院分区：
文献类型：
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作者：
Hong, Suk Jin;Park, Hyo Jung;Choe, Byung-Ho
目的：乙型肝炎e抗原（HBeAg）阳性慢性乙型肝炎病毒（CHB）感染儿童的自发血清转换率低于成人。然而，很少有研究调查儿童从免疫耐受阶段过渡到早期免疫清除阶段的速度。方法：2000年2月至2011年8月，在庆北大学附属医院儿科就诊的年龄< 18岁的儿童133例。所有受试者均处于hbeag阳性CHB病毒感染的免疫耐受期。使用Kaplan-Meier方法计算进入早期免疫清除阶段的估计过渡率。结果：在133例hbeag阳性免疫耐受期的儿童CHB病毒感染患者中，只有21例（15.8%）儿童转化为早期免疫清除期。进入活动性肝炎的平均年龄为10.6±4.8岁。在这些儿童中，从免疫耐受阶段过渡到早期免疫清除阶段的发生率为1.7次/100患者年。当按年龄分析时，< 6岁、6-12岁和6-12岁患者的估计转移率分别为4.6%、7.1%和28.0%。结论：在CHB病毒感染儿童中，12-18岁患者进入早期免疫清除期的估计率为28.0%，显著高于< 12岁儿童（11.7%,p=0.001）。
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).