title: Treatment of children with HBeAg-positive chronic hepatitis B: a systematic review and meta-analysis.
abstract: BACKGROUND
  Effective management of children with chronic hepatitis B is still an unresolved issue.
  
  
  OBJECTIVE
  To assess the outcome of different therapeutic regimens among children with HBeAg-positive chronic hepatitis B.
  
  
  METHODS
  Electronic database searches identified clinical trials that completed specific periods of treatment and follow-up. Sustained response rates were defined by the loss of HBV DNA and HBeAg, and by the normalization of liver enzymes. The loss of HBsAg and seroconversion to anti-HBs were also listed.
  
  
  RESULTS
  Our searches found 20 eligible articles (1112 enrolled patients, 2-18 years old). Interferon-alpha therapy showed significantly higher sustained response rate and loss of HBsAg than no therapy (Odd's ratio 3.0, 95% confidence interval 1.6-5.4; and 2.3, 1.1-11.3, respectively). The sustained response rate was not significantly different between interferon and interferon plus lamivudine, or plus prednisone, or plus hepatitis B vaccine; this rate was significantly higher for interferon compared with combined interferon plus levamisole or vitamin E.
  
  
  CONCLUSIONS
  Interferon-alpha is still the most effective treatment option for children with HBeAg-positive chronic hepatitis B. Randomized trials are warranted for further comparing interferon to newer antiviral agents in terms of efficacy, safety, emergence of mutant variants, and cost/benefit ratio.
authors.affiliation: Research Unit, Tanta Fever Hospital, Tanta, Egypt. Electronic address: azza_el_sherbini@yahoo.com.
authors.forename: Azza
authors.initials: A
authors.lastname: El Sherbini
authors.affiliation: Public Health, Preventive and Social Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Asmaa
authors.initials: A
authors.lastname: Omar
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D006513:Hepatitis B e Antigens; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D015233:Models, Statistical; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha
keywords: Children; Chronic hepatitis B; Meta-analysis; Treatment