https://scholars.lib.ntu.edu.tw/handle/123456789/376188
標題: | Long-term follow-up of children with postnatal immunoprophylaxis failure who were infected with hepatitis B virus surface antigen gene mutant | 作者: | HONG-YUAN HSU MEI-HWEI CHANG YEN-HSUAN NI YUNG-MING JENG Chiang, Cheng-Lun HUEY-LING CHEN JIA-FENG WU PEI-JER CHEN |
公開日期: | 2013 | 卷: | 207 | 期: | 7 | 起(迄)頁: | 1047-1057 | 來源出版物: | Journal of Infectious Diseases | 摘要: | Background. The long-term evolution and outcomes of infection with a hepatitis B virus (HBV) surface antigen (HBsAg) gene mutant (hereafter, "HBsAg-mutant HBV") among immunized children remain unclear.Methods. Ninety-five HBsAg-positive children aged 0.5-18.4 years (mean age, 5.8 years) who did not respond to postnatal immunoprophylaxis were prospectively followed for 1-22.8 years (mean follow-up, 8.5 years). Clinical, serologic, and virologic features were compared between 38 untreated HBV e antigen (HBeAg)-positive children carrying HBsAg-mutant HBV (group 1) and 49 children carrying wild-type HBV (group 2). HBsAg-mutant HBV was examined in 20 immunized children presenting with HBV-related hepatocellular carcinoma (HCC).Results. The initial alanine aminotransferase (ALT) level, the maximal ALT level during the HBeAg-positive phase of HBV infection, the cumulative incidence of HBeAg seroconversion (P =. 0018), and the rate of low serum HBV DNA load (defined as <104 copies/mL) at the last visit (P =. 006) were higher in group 1 than in group 2. A higher frequency of HBV genotype C and a higher ALT level during surface mutant viremia were observed in codon 110-129 mutants than in codon 144-145 mutants. None of the 95 patients developed cirrhosis or HCC. HBsAg-mutant HBV was detected in 3 of 8 (38%) HBV DNA-positive children with HCC.Conclusions. HBeAg-positive immunized children carrying HBsAg-mutant HBV may develop hepatitis activity, HBeAg seroconversion, and a low viremic state earlier than those carrying wild-type HBV. Continuous monitoring of children with wild-type HBV infection and those with HBsAg-mutant HBV for possible development of HCC is needed. ? 2013 The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-84874735359&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/376188 |
DOI: | 10.1093/infdis/jis943 | SDG/關鍵字: | alanine aminotransferase; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; virus DNA; adolescent; adult; alanine aminotransferase blood level; article; blood sampling; child; clinical feature; codon; female; follow up; genotype; hepatitis B; Hepatitis B virus; human; human tissue; immunoprophylaxis; incidence; infant; liver cell carcinoma; long term care; major clinical study; male; outcome assessment; preschool child; priority journal; school child; seroconversion; treatment duration; treatment failure; virus detection; virus load |
顯示於: | 醫學教育暨生醫倫理學科所 |
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