Chronic Hepatitis Is Common and Often Untreated Among Children with Hepatitis B Infection in the United States and Canada.
Chronic Hepatitis Is Common and Often Untreated Among Children with Hepatitis B Infection in the United States and Canada.
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DOI：
10.1016/j.jpeds.2021.05.035
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Hepatitis B Research Network (HBRN)
中科院分区：
文献类型：
--
作者：
Ling SC;Lin HS;Murray KF;Rosenthal P;Mogul D;Rodriguez-Baez N;Schwarzenberg SJ;Teckman J;Schwarz KB;Hepatitis B Research Network (HBRN)
为了确定在美国和加拿大的一大批前瞻性研究儿童中慢性乙肝病毒(乙肝病毒)感染的结局。这是一项在7个临床中心登记的慢性乙肝儿童的前瞻性观察研究，在基线、24周和48周以及此后每年进行评估，分析人口统计学、临床、体检和血液测试数据。在362名儿童中，在最后一次评估中，72%的儿童丙氨酸氨基转移酶(ALT；1 ULN)水平升高，其中60%的儿童在随访期间HBeAg丢失，70%的儿童在基线时HBeAg阴性。13例患儿出现明显ALT耀斑(男≥400U/L，女≥350U/L)。在随访期间符合AASLD治疗标准的129名儿童中，只有25名儿童开始了抗乙肝治疗。1名儿童死亡(与肝病无关)，1名儿童发展为肝硬变，但未观察到肝硬变失代偿或肝细胞癌。血小板计数下降与ALT升高呈负相关。在美国和加拿大慢性乙肝病毒感染的儿童队列中，许多儿童仍有因活动性肝炎而患上进展性肝病的风险，但主要的临床结果，如肝硬变、癌症和死亡是罕见的。许多符合治疗标准的儿童仍然没有接受治疗。
To determine the outcomes of chronic hepatitis B virus (HBV) infection in a large, prospectively studied cohort of children in the USA and Canada. A prospective observational study of children with chronic HBV enrolled in 7 clinical centers and evaluated at baseline, weeks 24 and 48, and annually thereafter, with analysis of demographic, clinical, physical examination and blood test data. Among 362 children followed for a median of 4.2 years, elevated alanine aminotransferase (ALT) levels (>1 ULN) were present in 72% at last evaluation, including in 60% of children with loss of HBeAg during follow-up and 70% of those who were HBeAg negative at baseline. Significant ALT flares (males ≥400 U/L, females ≥350 U/L) occurred in 13 children. Of 129 children who fulfilled AASLD treatment criteria during follow-up, anti-HBV treatment was initiated in only 25. One child died (unrelated to liver disease), 1 developed cirrhosis, but no episodes of cirrhotic decompensation or hepatocellular carcinoma were observed. Decline in platelet count was inversely associated with ALT elevations. In a cohort of children with chronic HBV infection in the US and Canada, many children remained at risk of progressive liver disease due to active hepatitis, but major clinical outcomes such as cirrhosis, cancer and death were rare. Many children who met criteria for treatment remained untreated.
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DOI：
10.1097/mpg.0000000000002712
发表时间：
2020-07
影响因子：
2.9
作者：
Rodriguez-Baez N;Murray KF;Kleiner DE;Ling SC;Rosenthal P;Carlin K;Cooper K;Schwarz KB;Schwarzenberg SJ;Teckman JH;Ghany MG;Alawad AS
通讯作者：
Alawad AS
DOI：
10.1136/adc.2002.009837
发表时间：
2004-09-01
影响因子：
4.4
作者：
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通讯作者：
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DOI：
10.5223/pghn.2014.17.1.41
发表时间：
2014-03-01
影响因子：
1.9
作者：
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通讯作者：
Choe, Byung-Ho
影响因子：
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作者：
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通讯作者：
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DOI：
10.1097/mpg.0000000000000567
发表时间：
2015-01-01
影响因子：
2.9
作者：
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通讯作者：
Fujisawa, Tomoo