Children with Chronic Hepatitis B in the United States and Canada

详细信息    查看全文

• 作者：Kathleen B. Schwarz ; MD¹ ; ^{kschwarz@jhmi.edu" class="auth_mail" title="E-mail the corresponding author} ; Yona Keich Cloonan ; PhD² ; Simon C. Ling ; MD³ ; Karen F. Murray ; MD⁴ ; Norberto Rodriguez-Baez ; MD⁵ ; Sarah Jane Schwarzenberg ; MD⁶ ; Jeffrey Teckman ; MD⁷ ; Lilia Ganova-Raeva ; PhD⁸ ; Philip Rosenthal ; MD⁹ ; on behalf of the Hepatitis B Research Network^&lowast ; Kathleen Schwarz ; Karen Murray ; Norberto Rodriguez-Baez ; Steven Belle ; Harry Janssen ; Simon Ling ; Norah Terrault ; Philip Rosenthal ; Lewis R. Roberts ; Sarah Jane Schwarzenberg ; Adrian Di Bisceglie ; Jeffery Teckman ; Lilia Milkova Ganova-Raeva ; Kathleen Schwarz ; Norah Terrault ; Hongxia Li ; MBBS ; MS ; Douglas Mogul ; MD ; Robert Anders ; MD ; PhD ; Kim Kafka ; RN ; Shannon M. Riggs ; LPN ; AS ; Rosemary Nagy ; RD ; MBA ; Jacki Cerkoski ; RN ; MSN ; Caitlin Yuan ; BSc ; MSc ; Rosemary Swan ; BN ; Constance O'Connor ; MN ; Laurie A. Rodgers-Augustyniak ; RN ; Shirley Montanye ; RN ; Shannon Fleck ; BS ; Camille Langlois ; MS ; Kara L. Cooper ; Michelle Danielson ; PhD ; Tamara Haller ; Geoffrey Johnson ; MS ; Stephanie Kelley ; MS ; Sharon Lawlor ; MBA ; Ruosha Li ; PhD ; Manuel Lombardero ; MS ; Joan M. MacGregor ; MS ; Andrew Pelesko ; BS ; Donna Stoliker ; Barbara Walters ; Ella Zadorozny ; MS
• 关键词：ALT ; Alanine aminotransferase ; HBeAg ; Hepatitis B envelope antigen ; HBRN ; Hepatitis B Research Network ; HBsAg ; Hepatitis B surface antigen ; HBV ; Hepatitis B virus ; HCC ; Hepatocellular carcinoma ; ULN ; Upper limit of normal
• 刊名：The Journal of Pediatrics
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：167
• 期：6
• 页码：1287-1294.e2
• 全文大小：479 K

文摘

To test the hypothesis that children with chronic hepatitis B living in the US and Canada would have international origins and characteristic hepatitis B virus (HBV) genotypes and laboratory profiles.

Study design

Clinical characteristics of children enrolled in the Hepatitis B Research Network were collected from 7 US and Canadian centers.

Results

Children (n = 343) with an age range of 1.0-17.8 years were enrolled; 78% of the children were Asian, 55% were adopted, and 97% had international origins with either the child or a parent born in 1 of 31 countries. The majority had HBV genotype B (43%) or C (32%), and the remainder had genotype A (5%), D (16%), E (4%), or multiple (<1%). Children with genotype B or C were more likely to be Asian (98% and 96%), more consistently hepatitis B envelope antigen positive (95% and 82%), had higher median HBV DNA levels (8.2 and 8.3 log₁₀ IU/mL), and less frequently had elevated alanine aminotransferase values (43% and 57%) compared with children with other genotypes. The percentage of hepatitis B envelope antigen positivity and of those with HBV DNA ≥6 log₁₀ IU/mL declined with age.

Conclusions

The majority of children in the Hepatitis B Research Network have HBV genotypes that reflect their international origins. Clinical and laboratory data differ substantially by patient age and HBV genotype. Use of these data can help drive the development of optimal strategies to manage and treat children with chronic hepatitis B.