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J Pediatr. 2015 Dec;167(6):1287-1294.e2. doi: 10.1016/j.jpeds.2015.08.021. Epub 2015 Sep 10.

Children with Chronic Hepatitis B in the United States and Canada.

Author information

1
Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD. Electronic address: kschwarz@jhmi.edu.
2
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
3
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
4
Department of Pediatrics, University of Washington, Seattle, WA.
5
Department of Pediatrics, University of Texas Southwestern, Dallas, TX.
6
Department of Pediatrics, University of Minnesota, Minneapolis, MN.
7
Department of Pediatrics, Saint Louis University, Saint Louis, MO.
8
Centers for Disease Control and Prevention, Atlanta, GA.
9
Department of Pediatrics, University of California, San Francisco, San Francisco, CA.

Abstract

OBJECTIVES:

To test the hypothesis that children with chronic hepatitis B living in the US and Canada would have international origins and characteristic hepatitis B virus (HBV) genotypes and laboratory profiles.

STUDY DESIGN:

Clinical characteristics of children enrolled in the Hepatitis B Research Network were collected from 7 US and Canadian centers.

RESULTS:

Children (n = 343) with an age range of 1.0-17.8 years were enrolled; 78% of the children were Asian, 55% were adopted, and 97% had international origins with either the child or a parent born in 1 of 31 countries. The majority had HBV genotype B (43%) or C (32%), and the remainder had genotype A (5%), D (16%), E (4%), or multiple (<1%). Children with genotype B or C were more likely to be Asian (98% and 96%), more consistently hepatitis B envelope antigen positive (95% and 82%), had higher median HBV DNA levels (8.2 and 8.3 log10 IU/mL), and less frequently had elevated alanine aminotransferase values (43% and 57%) compared with children with other genotypes. The percentage of hepatitis B envelope antigen positivity and of those with HBV DNA ≥6 log₁₀ IU/mL declined with age.

CONCLUSIONS:

The majority of children in the Hepatitis B Research Network have HBV genotypes that reflect their international origins. Clinical and laboratory data differ substantially by patient age and HBV genotype. Use of these data can help drive the development of optimal strategies to manage and treat children with chronic hepatitis B.

PMID:
26364985
PMCID:
PMC4662884
DOI:
10.1016/j.jpeds.2015.08.021
[Indexed for MEDLINE]
Free PMC Article

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