Journal of Infectious Diseases & Therapy
Open Access

Abstract

Results: In this study 227 naive children with chronic hepatitis B (CHB) infection were evaluated retrospectively . Of the total
227 pediatric patients who have CHB infection, 70(30.8%) developed either spontaneous seroconversion or seroconversion
during their eight year follow-up period. Of 157 patients who did not develop spontaneous seroconversion, 49 were treated
with two different treatment modalities as they met the treatment criteria.
The average age of 227 patients who participated in the study was 173 months and the average diagnosis period was 35
months. 56% of the patients were identified during family screening. The existence of hepatitis B in the family was 85,9%,
maternal hepatitis B was 60,4% and vertical transmission rate was 54,6%. 74% of the patients were asemptomatic.
When the patients who had spontaneous seroconversion and those who had no spontaneous seroconversion are examined,
it is seen that the average age (192 months) and diagnosis period (132 months) in the patients with spontenous seroconversion
was statistically higher and longer than those without spontenous seroconversion (156 vs 109, respectively) (p<0.01). The rate
of spontaneous seroconversion in males was statistically lower (p<0.01). Spontaneous seroconversion was statistically greater in
the patients who had lower viral load and ALT value at the time of the diagnosis and who had IgG antibodies against hepatitis
A virus (p<0.01, p<0.05 respectively). The patients with no spontaneous seroconversion had statistically higher familial and
vertical contamination (p<0.05).
A total of 49 patients with CHB infection were prospectively allocated to two random groups. Twenty-five patients in
the monotherapy group (Group I) whereas 24 patients in the combination therapy group (Group II). Serum ALT value was
higher in the patients in Group I than in those in Group II (p=0.06). While the patients who received IFN-α in Group I, were
identified with 8% of Anti-HBs seroconversion, 36% of Anti-HBe seroconversion, those who received IFN-α + LAM in Group
II had 8,3% of Anti-HBs seroconversion and 25% of Anti-HBe seroconversion.
Twenty-nine (59.2%) patients who responded to treatment and 20 (40,8%) who did not respond to treatment is examined,
it is seen that no statistically significant difference was found between the parameters under investigation in these groups.
Anti-HBs seroconversion in the patients who responded to treatment and received IFN monotherapy occurred within nearly
37 month follow-up period whereas, the response period was found to be 21 months in the patients who received IFN+LAM.
Anti-HBe seroconversion in the patients who received IFN monotherapy was observed in 26 month follow-up period while
this period was found to be 33 months in the patients who received IFN+LAM.
Discussion: The findings of this study suggest that long follow-up period (an avareage of 10 years) for the patients who
have been diagnosed with chronic hepatitis B and who do not meet the treatment criteria is essential in terms of spontenous
seroconversion development. Hepatitis A vaccination in seronegative patients may induce spontaneous seroconversion.
However, more detailed research studies are needed about this subject.
In this study, no statistically significant difference was found in terms of response to treatment between the two different
treatment modalities given to the patients who met treatment criteria. The potential benefits of these two theuropatic regimens
need to be futher investigated to confirm these results with larger number of patients.

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