Absence or delayed appearance of hepatitis B core antibody in chronic hepatitis B surface antigen carrier children
Journal
Journal of Hepatology
Journal Volume
17
Journal Issue
2
Pages
150-154
Date Issued
1993
Author(s)
Abstract
An absence of the hepatitis B core antibody (anti-HBc) in hepatitis B surface antigen (HBsAg) carrier children has been reported before, but whether anti-HBc will ultimately appear is unknown. In a group of 420 HBsAg carrier children who were followed longitudinally, 10 (2.4%) had an absence or delayed appearance of serum anti-HBc. These 10 children were persistently seropositive for HBsAg, hepatitis B e-antigen, and hepatitis B virus DNA (HBV-DNA). Anti-HBc never appeared in 4, one of whom was a case of hepatitis B vaccine failure and became an HBsAg carrier. Three of the 4 were born to HBsAg carrier mothers. Liver biopsy in one revealed non-specific reactive hepatitis (NSRH). All 4 were asymptomatic during follow-up. Mothers of the other 6 children who had delayed appearance of anti-HBc were also HBsAg carriers. The children seroconverted to anti-HBc positivity between 2 and 8 years of age, and the titer of serum anti-HBc at the first appearance varied. There were no significant changes in liver function tests, HBV-DNA levels, or associated symptoms and signs before and after seroconversion. Liver biopsies were performed before anti-HBc seroconversion in 2 children and showed NSRH. All 10 children had a moderate to high replication of HBV as shown by the high titer of HBsAg and HBV-DNA. The absence of anti-HBc occurred almost exclusively in children who were infected perinatally. The delayed appearance of anti-HBc in our cases suggests that although an immune tolerance to hepatitis B core antigen exists in early infancy, this tolerance eventually wanes with anti-HBc formation, and is not associated with marked hepatocellular damage as revealed by insignificant changes in biochemical, viral and serological data before and after anti-HBc seroconversion. ? 1993 Elsevier Scientific Publishers Ireland Ltd. All rights reserved.
SDGs
Other Subjects
hepatitis b core antibody; hepatitis b surface antigen; article; child; controlled study; female; hepatitis b; human; infant; major clinical study; male; priority journal; seroconversion; Biological Markers; Carrier State; Child; Child, Preschool; DNA, Viral; Female; Follow-Up Studies; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Core Antigens; Hepatitis B Surface Antigens; Hepatitis B Virus; Human; Infant; Infant, Newborn; Liver; Male; Support, Non-U.S. Gov't; Time Factors
Type
journal article