Source: J Pediatr Gastroenterol Nutri | Posted 4 days ago
Hepatitis B Virus Genotype Change In Children Is Closely Related to HBeAg/anti-HBe Seroconversion; Wirth S, Bortolotti F, Brunert C, Postberg J, Hensel K, Jenke A; Journal of Pediatric Gastroenterology and Nutrition (Apr 2013)
OBJECTIVES:: Genotype changes have been observed during long-term follow-up in adults with chronic hepatitis B virus (HBV) infection. The aim of this study was to assess the frequency and distribution of HBV genotype shifts in treated and untreated European children during the different phases of chronic hepatitis B. PATIENTS AND METHODS:: The initial population consisted of 85 HBeAg positive children who were sequentially investigated for HBV genotypes over a mean time period of 7.1 years. During the survey 65 patients seroconverted to anti-HBe and 24 received antiviral treatment. Genotyping was done by restriction fragment length polymorphism. RESULTS:: Genotypes at enrolment were distributed as follows: D (n = 67), A (n = 11), B (n = 4), C and mixed (n = 3). A genotype change was observed in 16 (19%) participants at last visit of whom 1/20 (5%) remained persistently HBeAg positive and 15/65 (23%) children had seroconverted to anti-HBe (p < 0.001). Genotype shift was: D to A or B in 9 individuals, A to D in 5, and A to B in one. Genotype changes were more frequent in untreated than in treated subjects; however, the difference was not statistically significant. CONCLUSION:: The results of this study suggest that genotype change is a relatively frequent event in children with chronic hepatitis B after anti-HBe seroconversion and independent of treatment. The reasons why only some patients will experience this event remain to be clarified. 作者: StephenW 时间: 2013-4-17 19:58