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Prevalence of hepatitis B virus precore stop codon mutations in chronically infected children

World Journal of Gastroenterology 2006年第14期12卷 2235-2238页

作者： Philip Wintermeyer patrick gerner Stephan Gehring Afshin Karimi Stefan Wirth Children's Hospital Helios Klinikum Wuppertal Witten-Herdecke UniversityGermany Children's Hospital University of Mainz Germany

AIM： To find out whether there is a significant difference in the prevalence of the precore stop codon mutation between HBeAg positive and anti-HBe positive children. METHODS： We investigated a large pediatric population of 155 European children （mean age 10.9 years） with chronic hepatitis B by PCR and direct sequencing. Ninety were HBeAg positive and 65 had seroconversion to anti-HBe. Additionally genotyping was performed. RESULTS： Seventy-four （48%） of the sequenced HBV strains were attributed to genotype D and 81 （52%） to genotype A. In the group of 90 HBeAg positive patients, 2 （2.2%） 1896-G-to-A transitions leading to precore stop codon mutation were found, and in the group of 65 anti-HBe positive children, 5 （7.7%） were identified harbouring HBeAg-minus mutants. The difference was not statistically significant （P= 0.13）. CONCLUSIONS： HBeAg minus variants as predominant viral HB strains play a minor role in the course of chronic hepatitis B in European children.

关键词： Hepatitis B Precore mutants Children HBeAg minus variants

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Prevalence of autoantibodies and the risk of autoimmune thyroid disease in children with chronic hepatitis C virus infection treated with interferon-α

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World Journal of Gastroenterology 2006年第36期12卷 5787-5792页

作者： Stephan Gehring Ulrike Kullmer Sabine Koeppelmann patrick gerner Philip Wintermeyer Stefan Wirth The Liver Research Center Department of Medicine Rhode Island Hospital and Brown Medical School Providence Rhode Island USA and Kinderklinik der Johannes-Gutenberg-Universitt Mainz Germany Kinderklinik der Johannes-Gutenberg-Universitt Mainz Germany Zentrum für Kinder-und Jugendmedizin HELIOS Klinikum Wuppertal Witten-Herdecke-University Germany

AIM： To evaluate the prevalence of autoantibodies in chronic hepatitis C virus （HCV）-infected children focusing on thyroid ***： We investigated the prevalence of autoantibodies in 123 chronic HCV-infected children before, during and after monotherapy with interferon-alpha （IFN-α） or combined treatment with interferon-α or peginterferon-α and ribavirin. Besides antibodies against smooth muscle （SMA）, nuclei （ANA）, and liver/kidney microsomes （1KM）, the incidence of antithyroid peroxidase antibodies as well as thyroid function parameters （TSH, FT3 and FT4） were ***： We found that 8% of children had autoantibodies before treatment. During treatment, 18% of children were found positive for at least one autoantibody; 15.5% of children developed pathologic thyroid values during IFN-α treatment compared to only one child before therapy. Six children had to be substituted while developing laboratory signs of ***： Our data indicate a strong correlation between interferon-α treatment and autoimmune phenomena, notably the emergence of thyroid antibodies. The fact that some children required hormone replacement underlines the need of close monitoring in particularly those who respond to therapy and have to be treated for more than 6 mo.

关键词： Hepatitis C treatment Children Thyroiddysfunction Autoantibodies

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Vitamin E treatment for children with chronic hepatitis B:A randomized placebo controlled trial

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World Journal of Gastroenterology 2008年第47期14卷 7208-7213页

作者： patrick gerner Hans-Georg Posselt Andreas Krahl Antje Ballauff Albina Innerhofer Christa Binder Tobias G Wenzl Matthias Zense Ariadne Hector Gerhard Dockter Rüdiger Adam Jenny Neubert Martin Claβen Robert van Gemmern Stefan Wirth Children's Hospital Duisburg-Essen University Klinik 2Essen 45122Germany Witten/Herdecke University HELIOS KlinikumWuppertalGermany Children's Hospital Frankfurt University Frankfurt am Main 60590Germany Children's Hospital Darmstadt 64287Germany Children's Hospital Essen University Klinik 2Essen 45122Germany Children's Hospital St.Anna Wien Austria 1090Germany Children's Hospital Aachen University Aachen 52074Germany Children's Hospital St.Clemens Münster 48153Germany Children's Hospital Homburg University Homburg/Saar 66421Germany Children's Hospital Mannheim University Mannheim 68167Germany Children's Hospital Düsseldorf University Düsseldorf 40225Germany Children's Hospital Bremen University Bremen 28195Germany Pharmacy of HELIOS Klinikum Wuppertal 42883Germany Children's Hospital HELIOS Klinikum Wuppertal42283Germany Witten/Herdecke University Witten/HerdeckeGermany

AIM:To evaluate the safety and efficacy of vitamin E in children with chronic hepatitis ***:We randomly assigned patients with chronic hepatitis B,positive for hepatitis B e antigen(HBeAg),to receive either vitamin E or placebo once daily for 6 mo in a 3:1 ratio and double-blind *** primary end point was HBeAg seroconversion,defined as the loss of HBeAg,undetectable levels of serum hepatitis B virus DNA,and the appearance of antibodies against HBeAg 12 mo after ***:At baseline visit,49 patients had normal and 43 had increased serum aminotransferase ***-nine patients did not respond to previous treatment with interferon-α or ***-six children completed the study;16 were non-compliant(n = 7),lost to follow-up(n = 7),or started another antiviral treatment(n = 3).Intention-to-treat analysis showed HBeAg seroconversion in 16 children(23.2%) treated with vitamin E and two(8.7%) in the placebo group(P = 0.13).Vitamin E was well ***:There is only a tendency that vitamin E may promote HBeAg *** larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis B.

关键词： Vertical transmission Immune tolerance Re-treatment Infant

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