Long term follow-up of children with chronic hepatitis B: a single center experience

Özet

Chronic Hepatitis B infection is an important clinical issue because ofthe associated risk of developing cirrhosis and hepatocellular carcinoma.Especially in children, there is no consensus about the optimal treatment.Clinical features and long-term outcomes of 165 children diagnosed withchronic hepatitis B at our institution between January 1993 and June 2012were analysed retrospectively. Patients were divided into four groupsaccording to their treatment protocols. The first group received Interferon(IFN) only, the second group started lamivudine (LMV) first then IFN+LMVcombined and then continued with LMV only, the third group started withIFN+LMV combined then continued with LMV only and the fourth groupreceived LMV only. After a median follow-up period of 7 years (1-19 years)the highest e-seroconversion (the loss of HBeAg followed by gain of antiHBe antibody) rate, biochemical and virological response was observed withcombined (IFN+LMV) treatment regimens. Patients with higher ALT levelswere better treatment responders (p: 0.003). Identification of the patientswho need to be treated in order to determine the most effective therapy withoptimal treatment duration is important to reduce the risk of developingfuture complications like cirrhosis and hepatocellular carcinoma.