慢性乙型肝炎患儿e抗原清除后调查:一项29年的纵向研究

作     者：Bortolotti F. Guido M. Bartolacci S. 王铮 

作者机构：Clinica Medica VVia Giustiniani 235100 PadovaItaly 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第9期

页      面：49-50页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：慢性乙型肝炎 e抗原 患儿 HBeAg阴性 HBeAg血清转换 HBeAg阳性 清除后 随访观察 

摘      要：Chronic hepatitis B is usually a benign disease in Caucasian children;however,the long-term prognosis remains unsettled.This report describes the results of a 29-year longitudinal study including 99 white children with chronic hepatitis B,mainly acquired horizontally:91 were hepatitis B e antigen(HBeAg)-positive(4 had cirrhosis),and 8 were HBeAg negative at presentation.Of the 91 HBeAg-positive children,89 underwent HBeAg seroconversion after a mean period of 5.2 ±4.0 years and were included in the study.Of the 85 children without cirrhosis,one had HBeAg-negative hepatitis and the other 84 became inactive carriers.During a mean follow-up of 14.5 ±6.1 years after HBeAg seroclearance,4 carriers experienced reactivation,and 3 of them had HBeAg-negative hepatitis at the last follow-up.Of the 8 initially HBeAg-negative children,2 had HBeAg-negative hepatitis,and 6 were inactive carriers.Of the 4 children with cirrhosis,2 had hepatocellular carcinoma(HCC)and remained alive and 2 lost the histological features of cirrhosis in adulthood.Two patients with HBeAg-negative hepatitis and 1 with cirrhosis had experienced drug abuse.At the end of follow-up,15 of the 89 initially HBeAg-positive patients and 2 of 8 initially HBeAg-negative children had cleared hepatitis B surface antigen.In conclusion,the overall prognosis for chronic hepatitis B in horizontally infected Caucasian children is favorable;however,some patients progress to HCC and HBeAg-negative hepatitis.Long-term monitoring is important,as is counseling on cofactors of liver damage,such as alcohol and drug abuse.