To investigate the HBsAg clearance rate after antiviral therapy in children with HBeAg-positive chronic hepatitis B (CHB) aged 1-7 years.

A retrospective analysis was performed for the HBsAg clearance rate in 293 children who were hospitalized in 302 Hospital of PLA from June 2006 to December 2013, met the inclusion criteria, received antiviral therapy, and were followed up for at least 6 months after the withdrawal of antiviral therapy. The t-test or the rank sum test was applied according to the distribution of continuous data, and the chi-square test was used for comparison of categorical data.

The HBsAg positive rate of children’s mothers was 91.1%. In the age groups of >1-≤2 years, >2-≤3 years, >3-≤4 years, >4-≤5 years, >5-≤6 years, and >6-≤7 years, the HBsAg clearance rates were 66.1%, 65.5%, 45.7%, 41.3%, 20.6%, and 27.6%, respectively. There were significant differences in HBsAg clearance rate between the age groups of >1-≤3 years and >3-≤5 years, >1-≤3 years and >5-≤7 years, and >3-≤5 years and >5-≤7 years ( P = 0.001, 0.000, and 0.008). Of all children, 64.8% were boys, among whom 41.1% achieved HBsAg clearance, and 35.2% were girls, among whom 61.2% achieved HBsAg clearance; there was a significant difference in HBsAg clearance rate between boys and girls (P = 0.001). The children with pretreatment alanine aminotransferase (ALT) levels of ≤80 IU/L, > 80 IU/L, ≤200 IU/L, and > 200 IU/L had HBsAg clearance rates of 40.7%, 51.2%, 47.6%, and 49.4%, respectively; there were no significant differences in HBsAg clearance rate between the ALT ≤80 IU/L and ALT > 80 IU/L groups and the ALT ≤200 IU/L and ALT > 200 IU/L groups ( P = 0.101 and 0.778). There was no significant difference in HBsAg clearance rate between the pretreatment HBV DNA load < 1×10 ⁷ IU/ml and ≥1×10⁷ IU/ml groups (54.9% vs 46.7%, P = 0.286). Of all children, 14.2% had genotype B and an HBsAg clearance rate of 57.1%, and 85% had genotype C and an HBsAg clearance rate of 39.5%; there was no significant difference in HBsAg clearance rate between the genotype B group and the genotype C group (P = 0.051). Of all children, 90.4% underwent liver biopsy, among whom 10.9% had severe liver fibrosis (F≥3) and liver cirrhosis, as well as an HBsAg clearance rate of 31%; the non-severe liver fibrosis/liver cirrhosis group had an HBsAg clearance rate of 49.2%, and there was no significant difference in HBsAg clearance rate between these two groups (P = 0.065). There was no significant difference in HBsAg clearance rate between the liver inflammation grade (G) < 2 group and the G ≥ 2 group (39.5% vs 50.9%, P = 0.084). Of all children, 58.7% received interferon antiviral therapy alone and had an HBsAg clearance rate of 48.8%, and 41.3% received interferon alone for 6 months followed by lamivudine antiviral therapy and had an HBsAg clearance rate of 47.1%; there was no significant difference between these two groups (P = 0.770).

In children with HBeAg-positive CHB aged 1-7 years who receive antiviral therapy, HBsAg clearance rate is correlated with age and sex, and the children aged < 5 years can achieve a higher HBsAg clearance rate.

Child; Hepatitis B, chronic; Hepatitis B surface antigens; Interferons