Natural history of hepatitis B virus infection in children.
Hepatitis B virus (HBV) infection during childhood can cause acute, fulminant or chronic hepatitis, liver cirrhosis, and liver cancer. Approximately 90% of the infants of hepatitis B e antigen (HBeAg) seropositive mothers become hepatitis B surface antigen (HBsAg) carriers. Children chronically infected are mostly asymptomatic. Although liver damage is usually mild during childhood, severe liver disease, including cirrhosis and hepatocellular carcinoma, may develop insidiously for 2-7 years. Spontaneous HBeAg seroconversion occurs gradually as the age of the child increases. Viral replication is reduced during this process, which is usually preceded by an elevation of aminotransferases. In a long-term follow-up study, the annual HBeAg seroconversion rate was 4-5% in children older than 3 years of age and less than 2% in children under 3 years. The annual seroconversion rate of HBsAg was very low (0.56%). Age at infection, maternal HBsAg and HBeAg status, host immune status, and possibly the HBV strain are the main factors determining the course of HBV infection in children.
Chang
M H
MH
Department of Paediatrics, College of Medicine, National Taiwan University, Taipei. mhchang@ha.mc.ntu.edu.tw
D001208:Asia; D002648:Child; D002675:Child, Preschool; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D019694:Hepatitis B, Chronic / Q000150:complications / Q000276:immunology / Q000473:pathology; D006801:Humans; D007223:Infant; D008099:Liver / Q000473:pathology
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens