Abstract

INTRODUCTION: The aim of this study was to investigate the relationship between demographic, clinical features and laboratory findings of children with chronic hepatitis B infection.

METHODS: The polyclinic files of patients with chronic hepatitis B infection who were followed-up by Selcuk University Faculty of Medicine Department of Pediatrics between 2012-2017 were evaluated retrospectively. Demographic and clinical features and laboratory findings of the patients were recorded. The age of patients determined as mean ± standard deviation and gender distribution as percentage. In statistical evaluation, parametric data were compared with Student-t test for independent samples and nonparametric data with chi-square test. The level of significance was p <0.05. All statistical analyzes were analyzed with SPSS 21.0 (IBM SPSS Statistics 21.0) package program.

RESULTS: There was 29 patients (12E / 17K) and the mean age was 14.97 ± 3.72 years. 89.7% mother of the patients had chronic hepatitis B infection. 82.8% of children had weakness and fatigue, 62.1% loss of appetite, 24.1% had right upper quadrant pain and 6.9% nausea. 48.3% of the patients had HBeAg positive. HBV DNA was positive in 11 of 15 patients who HBeAg negative and in all 14 patients who HBeAg positive (p = 0.037). ALT level was normal in 65.5% of patients. The mean ALT level was higher in HBeAg positive (p = 0.047) and in HBV DNA positive patients (p = 0.031) than in the negative patients. There was no statistically significant relationship between clinical findings and laboratory findings. Liver biopsy was performed in 12 (41.4%) patients, and histological activity was ≥4 in 7 (58.3%) and fibrosis ≥2 in 5 (41.7%). In 5 of the patients (17.2%) interferon alpha 2b, in 2 patients interferon alpha 2b + lamivudine (6.9%) combined therapy and in 2 (6.9%) only lamivudine was used and seroconversion developed and HBV DNA became negative. Currently, 2 patients (6.9%) had tenofovir and 1 (3.4%) had entecavir therapies.

CONCLUSION: The most important factor in the etiology of children with chronic hepatitis B infection is transmission from mother to child. The most common symptoms are weakness and fatigue. Although HBeAg is negative, the incidence of HBV DNA positive patients is significant. Patients with HBeAg and / or HBV DNA positivity had higher mean ALT levels.