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. 1981 Jun;22(6):499–504. doi: 10.1136/gut.22.6.499

Chronic hepatitis type B in childhood: longitudinal study of 35 cases.

F Bortolotti, P Cadrobbi, C Crivellaro, A Bertaggia, A Alberti, G Realdi
PMCID: PMC1419274  PMID: 7262628

Abstract

Clinical, virological, and histological features of hepatitis B virus infection have been examined in 35 children, aged 1 to 11 years, known to be hepatitis B surface antigen (HBsAg) carriers for at least six months when entering the study. Only 10 patients had a history of acute unresolved hepatitis: in the remaining cases the detection of HBsAg had been an occasional finding. Although 77% of the patients were asymptomatic, all had evidence of hepatic involvement and liver history showed the features of chronic persistent hepatitis in 18 cases and of chronic active hepatitis in 16 cases, with associated cirrhosis in two of them. One patient had only minimal histological changes. A high percentage of children with both chronic persistent and chronic active hepatitis had evidence of active virus replication throughout the observation period. During the follow-up study of one to eight years (mean 3.1 +/- 1.7 years), transaminase levels became consistently normal in five patients with chronic persistent hepatitis, and inflammatory infiltrates disappeared in three of them. However, only one of these children cleared HBsAg from serum. Eleven of 16 patients with chronic active hepatitis received immunosuppressive treatment but only one of them achieved a complete and protracted remission, although active viral replication persisted. On the other hand, two of five untreated patients reached complete remission after two and three years of follow-up respectively and one of them cleared HBsAg three years later. These results would suggest the possibility of a spontaneous complete remission of HBsAg positive chronic active hepatitis in children but also raise doubts about the usefulness of immunosuppressive therapy in such patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arasu T. S., Wyllie R., Hatch T. F., Fitzgerald J. F. Management of chronic aggressive hepatitis in children and adolescents. J Pediatr. 1979 Oct;95(4):514–522. doi: 10.1016/s0022-3476(79)80754-4. [DOI] [PubMed] [Google Scholar]
  2. Colombo M., Gerber M. A., Vernace S. J., Gianotti F., Paronetto F. Immune response to hepatitis B virus in children with papular acrodermatitis. Gastroenterology. 1977 Nov;73(5):1103–1106. [PubMed] [Google Scholar]
  3. De Groote J., Desmet V. J., Gedigk P., Korb G., Popper H., Poulsen H., Scheuer P. J., Schmid M., Thaler H., Uehlinger E. A classification of chronic hepatitis. Lancet. 1968 Sep 14;2(7568):626–628. doi: 10.1016/s0140-6736(68)90710-1. [DOI] [PubMed] [Google Scholar]
  4. Dupuy J. M., Kostewicz E., Alagille D. Hepatitis B in children. I. Analysis of 80 cases of acute and chronic hepatitis B. J Pediatr. 1978 Jan;92(1):17–20. doi: 10.1016/s0022-3476(78)80062-6. [DOI] [PubMed] [Google Scholar]
  5. Gianotti F. Papular acrodermatitis of childhood. An Australia antigen disease. Arch Dis Child. 1973 Oct;48(10):794–799. doi: 10.1136/adc.48.10.794. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Kaplan P. M., Greenman R. L., Gerin J. L., Purcell R. H., Robinson W. S. DNA polymerase associated with human hepatitis B antigen. J Virol. 1973 Nov;12(5):995–1005. doi: 10.1128/jvi.12.5.995-1005.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Merrill D. A., Dubois R. S., Kohler P. F. Neonatal onset of the hepatitis-associated-antigen carrier state. N Engl J Med. 1972 Dec 21;287(25):1280–1282. doi: 10.1056/NEJM197212212872506. [DOI] [PubMed] [Google Scholar]
  8. Mowat A. P. Viral hepatitis in infancy and childhood. Clin Gastroenterol. 1980 Jan;9(1):191–212. [PubMed] [Google Scholar]
  9. Okada K., Yamada T., Miyakawa Y., Mayumi M. Hepatitis B surface antigen in the serum of infants after deliver from asymptomatic carrier mothers. J Pediatr. 1975 Sep;87(3):360–363. doi: 10.1016/s0022-3476(75)80635-4. [DOI] [PubMed] [Google Scholar]
  10. Realdi G., Alberti A., Rugge M., Bortolotti F., Rigoli A. M., Tremolada F., Ruol A. Seroconversion from hepatitis B e antigen to anti-HBe in chronic hepatitis B virus infection. Gastroenterology. 1980 Aug;79(2):195–199. [PubMed] [Google Scholar]
  11. Schweitzer I. L. Infection of neonates and infants with the hepatitis B virus. Prog Med Virol. 1975;20:27–48. [PubMed] [Google Scholar]
  12. Skinhøj P. Infection with hepatitis B virus in infancy. A longitudinal study of 8 cases. Arch Dis Child. 1978 Sep;53(9):746–748. doi: 10.1136/adc.53.9.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Stevens C. E., Beasley R. P., Tsui J., Lee W. C. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med. 1975 Apr 10;292(15):771–774. doi: 10.1056/NEJM197504102921503. [DOI] [PubMed] [Google Scholar]

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