title: Effect of menarche onset on the clinical course in females with chronic hepatitis B virus infection.
abstract: OBJECTIVE
  To investigate the impact of menarche on the natural course of chronic hepatitis B virus (HBV) infection in women.
  
  
  METHODS
  Young women who are positive for hepatitis B e antigen (HBeAg; n = 101) chronically infected with genotypes B and C HBV were recruited at a mean age of 4.57 ± 3.08 years, and a mean follow-up duration of 23.98 ± 3.77 years. Clinical data, including age at menarche, HBV genotypes, serum HBV viral loads, hepatitis B surface antigen (HBsAg) titers, and serial liver functional profiles were analyzed.
  
  
  RESULTS
  Women with earlier onset of menarche had earlier spontaneous HBeAg seroconversion than others (hazard ratio, 2.0; P = .02) adjusting for HBV genotype and peak alanine aminotransferase levels before HBeAg seroconversion. The annual decrease in HBsAg titer from 15 to 20 years of age also was greater in the early menarche group compared with the late menarche group (0.11 ± 0.11 vs 0.05 ± 0.11 log10 IU/mL, P = .04). The baseline HBV viral load was also borderline low in female subjects with earlier menarche as compared with others (P = .06). Earlier menarche onset was associated with higher spontaneous HBeAg seroconversion, HBsAg seroclearance, and HBsAg seroconversion rate before 15 years of age in females with chronic HBV infection.
  
  
  CONCLUSIONS
  Earlier puberty-onset, indicated by menarche-onset, was associated with earlier spontaneous HBeAg seroconversion and greater rate of HBV clearance before 15 years of age in female subjects with chronic HBV infection.
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors: Jia-Feng
authors: JF
authors: Wu
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors: Wen-Yu
authors: WY
authors: Tsai
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors: Yi-Ching
authors: YC
authors: Tung
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
authors: Huey-Ling
authors: HL
authors: Chen
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Genetics, National Taiwan University Hospital, Taipei, Taiwan.
authors: Yen-Hsuan
authors: YH
authors: Ni
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors: Hong-Yuan
authors: HY
authors: Hsu
authors: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: changmh@ntu.edu.tw.
authors: Mei-Hwei
authors: MH
authors: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000276:immunology*; D006801:Humans; D008572:Menarche; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens