Evaluation of viral replication in children with chronic hepatitis B with and without interferon treatment.
BACKGROUND
In chronic infection with hepatitis virus B the fact that HBeAg becomes negative does not always mean suppression of viral replication.


METHODS
HBV replication was assessed in 74 patients with chronic hepatitis or viral B cirrhosis, in whom diagnosis was made according to clinical, biological, and histological criteria. The patients were divided into two groups: group I (36 patients with interferon- therapy, 3 million U/m 2/ dose, 3 doses/week over a period of 4-6 months) and group II (control group of 38 patients who did not undergo interferon therapy). After a follow up period of 6 years in which patients underwent clinical, biochemical and serologic monitorization, HBV DNA was detected by the hybridization method on solid medium.


RESULTS
During evolution the levels of transaminases became normal in both groups. The HBe Ag/Ab seroconversion rate at the end of the interferon therapy was 52.8% and the spontaneous HBe Ag/Ab seroconversion rate was 72.7% in group II after an average evolution of 6 years. HBs Ag/Ab seroconversion was not detected in any patient. Assessment of viral replication by HBV DNA testing at the end of the follow up period showed higher levels as compared to the HBeAg testing (69.4% vs. 25% in group I, 55.2% vs. 7.9% in group II). The absence of viral replication (HBV DNA negative) had similar rates in both groups (30.6% in group I vs. 44.8% in group II, p>0.9) and HBV DNA titers in the two groups were not significantly different at the end of the follow up period. In both groups, HBV DNA titers were significantly higher in patients with positive HBeAg. The concordance between the two viral markers was 100%.


CONCLUSIONS
Because of the fluctuating evolution, long-term follow up and monitorization (including HBV DNA testing) of patients with chronic hepatitis B and of inactive HBsAg carriers are necessary.
Lazăr
Călin
C
Axente Iancu, 1st Pediatric Clinic, Iuliu Moldovan Institute of Hygine, Cluj-Napoca, Romania. calinlazar2004@yahoo.com
Grigorescu-Sido
Paula
P
Manasia
Rodica
R
Mireştean
Stefan
S
Skorka
Cristina
C
Neculoiu
Daniela
D
Molnar
Geza
G
Cocean
Stela
S
D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006511:Hepatitis B Antigens / Q000032:analysis / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis; D008297:Male; D014779:Virus Replication
D000998:Antiviral Agents; D004279:DNA, Viral; D006511:Hepatitis B Antigens; D016898:Interferon-alpha