Chronic hepatitis B in children after e antigen seroclearance: Final report of a 29-year longitudinal study

Bortolotti, Flavia; Guido, Maria; Bartolacci, S.; Cadrobbi, P; Crivellaro, Carlo; Noventa, Franco; Morsica, Giulia; Moriondo, Maria; Gatta, Angelo

doi:10.1002/hep.21077

Cited by 207 publications

(211 citation statements)

References 36 publications

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“…This inflammatory phase also leads commonly to HBeAg seroconversion and entry into inactive HBsAg carrier status (the third phase of chronic infection). Spontaneous HBeAg seroconversion has been observed in 66% to 98% of prospectively studied cohorts (26) and occurs at an estimated rate of 10% per year (10,100).…”

Section: Hbv Infectionmentioning

confidence: 99%

Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Valsamakis

2007

Clin Microbiol Rev

137

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SUMMARY Hepatitis B virus (HBV) is an enveloped virus with a small (3.2-kb) partially double-stranded DNA genome that causes acute and chronic infections. The impact of these infections on public health worldwide is enormous, with an estimated prevalence of 2 billion acute infections and 360 million chronic infections globally. This review focuses on chronic hepatitis B and the molecular assays used in its diagnosis and management. Background information, including that about features of the hepatitis B virion, viral replication, and epidemiology of infection, that is important for understanding chronic hepatitis B and molecular diagnostic tests for HBV is provided. To facilitate an understanding of the utility of molecular testing for chronic hepatitis B, the four stages of chronic hepatitis B infection that are currently recognized, as well as an additional entity, occult hepatitis B, that can be diagnosed only by sensitive nucleic acid amplification methods, are reviewed in detail, including available therapeutic agents. The molecular diagnostic content focuses on tests for HBV DNA quantification, genotyping, and mutation detection (including precore/core promoter and antiviral resistance mutations). The discussion of these tests encompasses their current utility and performance characteristics, drawing from current clinical guidelines and other studies from the literature. In recognition of the continual evolution of this field, the final section describes emerging molecular markers with future diagnostic potential.

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Section: Hbv Infectionmentioning

confidence: 99%

Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Valsamakis

2007

Clin Microbiol Rev

137

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“…19 The long term study (29 years) of Caucasian children who infected with chronic HBV showed that 91 children had positive results with HBsAg test. 3 The human often acquires HBV infection during the first time of its life by different routes. A baby can get hepatitis B from an infected mother as perinatal transmission at childbirth.…”

Section: Discussionmentioning

confidence: 99%

“…2 Recently, there are many methods used for the diagnosis of HBV infection through detection of viral antigen that found in either of serum (most common) or in biopsy examination. [3][4][5][6] Although it is expensive for most of clinical laboratories and needs a time, different types of ELISA techniques revealed more accuracy and suitability to detect HBV antigens. Rapid assay (RA) considers one of the simplest application methods in comparison with ELISA which is depended in most of them on chromatography method.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of a rapid assay for diagnosis of hepatitis B virus infection in early ages with high levels of bilirubin

2016

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Background: The infection by hepatitis B virus (HBV) considers one of the common types of viral disease that can infect all ages of the human. Babies and children as an early age of the human life are usually infected by such type of virus with high incidence rates all over the world. An evaluation of a rapid assay (RA) in comparison with ELISA for diagnosis of HBV infection in early ages patients with a high level of bilirubin was investigated in the present study.Methods: A total of 86 early age patients with high bilirubin levels (35 babies and 51 children) were involved in this study. Sandwich ELISA and RA were applied to detect HBsAg of HBV in the patient's blood samples. Results: According to the rapid assay, all of our patients were shown a negative result for HBV infection, while the application of sandwich ELISA showed positive results in two of them (child and baby).Conclusions: The RA could be used as a second chose to detect HBV infection after ELISA. The diagnostic device produce by ABNO company which was used as one of the RA was revealed less effective to detect HBV infection.

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“…Previous long-term follow-up observational studies have shown that 13%-38% of children received treatment during childhood, (20,21,24,25) and that by age 20 years, 6%-10% of patients with perinatal HBV are no longer HBsAg positive, 0%-2% develop HCC, 1%-4% develop cirrhosis, and around half became an inactive carrier. (20,21,24,26) Based on these findings, we assumed that 25% of children received treatment before age 20 years with an estimated cost of $10,000 (based on 1 year of antiviral treatment, i.e., tenofovir, entecavir, or pegylated interferon-alpha), (27)(28)(29) and that that by age 20 years, 8% of patients with perinatal CHB cleared HBsAg, 45% achieved inactive carrier status, 45% developed active CHB status, 1% developed HCC,, and 1% developed cirrhosis. We assumed that before age 20 years, all children received assessment for disease progression twice a year, and that the assessment included HBsAg and HBeAg status, HBV-DNA load, presence of hepatomegaly and splenomegaly, measurement of ALT, aspartate aminotransferase, alkaline phosphatase, alpa-fetoprotein, total bilirubin, full blood count, synthetic function of the liver with serum albumin and prothrombin time or international normalized ratio, and ultrasound scan.…”

Section: Article Informationmentioning

confidence: 99%

Cost‐effectiveness of active‐passive prophylaxis and antiviral prophylaxis during pregnancy to prevent perinatal hepatitis B virus infection

et al. 2015

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In an era of antiviral treatment, reexamination of the cost-effectiveness of strategies to prevent perinatal hepatitis B virus (HBV) transmission in the United States is needed. We used a decision tree and Markov model to estimate the costeffectiveness of the current U.S. strategy and two alternatives: (1) Universal hepatitis B vaccination (HepB) strategy: No pregnant women are screened for hepatitis B surface antigen (HBsAg). All infants receive HepB before hospital discharge; no infants receive hepatitis B immunoglobulin (HBIG). (2) Current strategy: All pregnant women are screened for HBsAg. Infants of HBsAg-positive women receive HepB and HBIG £ 12 hours of birth. All other infants receive HepB before hospital discharge. (3) Antiviral prophylaxis strategy: All pregnant women are screened for HBsAg. HBsAg-positive women have HBV-DNA load measured. Antiviral prophylaxis is offered for 4 months starting in the third trimester to women with DNA load 10 6 copies/mL. HepB and HBIG are administered at birth to infants of HBsAg-positive women, and HepB is administered before hospital discharge to infants of HBsAg-negative women. Effects were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Compared to the universal HepB strategy, the current strategy prevented 1,006 chronic HBV infections and saved 13,600 QALYs (ICER: $6,957/QALY saved). Antiviral prophylaxis dominated the current strategy, preventing an additional 489 chronic infections, and saving 800 QALYs and $2.8 million. The results remained robust over a wide range of assumptions. Conclusion: The current U.S. strategy for preventing perinatal HBV remains cost-effective compared to the universal HepB strategy. An antiviral prophylaxis strategy was cost saving compared to the current strategy and should be considered to continue to decrease the burden of perinatal hepatitis B in the United States. (HEPATOLOGY 2016;63:1471-1480 A n estimated 0.8-1.4 million individuals in the United States are chronically infected with hepatitis B virus (HBV).(1) Among foreignborn individuals, the prevalence can be 7%.(2) Perinatal HBV infection is an important source of chronic hepatitis B (CHB). Approximately 90% of HBVinfected infants will develop CHB, with a 25% risk of premature death from liver failure or hepatocellular carcinoma (HCC).(3-5) The degree of risk for perinatal HBV transmission varies by maternal hepatitis B e antigen (HBeAg) and HBV-DNA load.(6) Without intervention, 5%-31% of infants born to women who are HBeAg negative or have low HBV-DNA load will be perinatally infected, compared to 85%-90% of infants born to women who are HBeAg positive or have high HBV-DNA load. Hepatitis B vaccination (HepB) can prevent up to 72% of HBV infections resulting from perinatal

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Chronic hepatitis B in children after e antigen seroclearance: Final report of a 29-year longitudinal study

Cited by 207 publications

References 36 publications

Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Efficiency of a rapid assay for diagnosis of hepatitis B virus infection in early ages with high levels of bilirubin

Cost‐effectiveness of active‐passive prophylaxis and antiviral prophylaxis during pregnancy to prevent perinatal hepatitis B virus infection

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