Spontaneous loss of chronic HBV infection markers in treatment-naïve children: a systematic review and pooled meta-analyses
Yuting Yang 1 2 3 4 5 6 , Ailong Huang 7 , Yao Zhao 1 2 3 4 5 6
Affiliations
Affiliations
1
Chongqing Key Laboratory of Child Infection and Immunity.
2
Department of Pediatric Research Institute.
3
Ministry of Education Key Laboratory of Child Development and Disorders.
4
National Clinical Research Center for Child Health and Disorders.
5
China International Science and Technology Cooperation base of Child development and Critical Disorders.
6
Children's Hospital of Chongqing Medical University , Chongqing, P.R China.
7
Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University , Chongqing, China.
PMID: 33164585 DOI: 10.1080/14787210.2021.1845652
Abstract
Objectives: Chronicity could be a serious threat to hepatitis B virus (HBV)-infected children. The necessity of antiviral treatment to HBV-infected children has caused much controversy. The authors aimed to conduct a systematic review and meta-analysis of synthesized evidence regarding the spontaneous loss of chronic HBV infection markers in treatment-naïve children for exploring their long-term management. Methods: Observational cohort studies and non-treatment arms of randomized controlled trials were searched that reported the spontaneous loss of chronic HBV infection markers in untreated children (characterized by the presence of HBsAg ≥6-month), via the rates of hepatitis B surface antigen (HBsAg) loss, hepatitis B e antigen (HBeAg) seroconversion, and HBV DNA suppression with random-effects model. Results: Of 7,427 studies screened, 20 were included in meta-analysis. With cumulative 23,153 person-years of follow-up, the pooled annual incidences of HBsAg and HBeAg loss, HBV DNA suppression were 1%, 6%, 7%, respectively. Rates within HBeAg loss and HBV DNA suppression did differ by the transmission modes and ALT levels, not in HBsAg. Conclusion: Spontaneous HBsAg loss (function cure) occurs infrequently in treatment-naïve children with chronic HBV infection. Design of practically applicable programs aiming at therapeutics of children may be necessary to support the goal of eliminate HBV infection worldwide.