Hepatitis B virus genotypes and the response to antiviral treatment in children with chronic hepatitis B

Abstract number: 1733_989

Dzierzanowska-Fangrat K., Woynarowski M., Socha J., Dzierzanowska D.

Objectives: Hepatitis B virus infection remains a serious health problem worldwide. One of the viral factors believed to be associated with the clinical outcome of the infection is the genetic variability of the virus. The aim of this study was to analyse the correlation between HBV genotype and the response to antiviral therapy in children with chronic hepatitis B.

Patients and Methods: A total of 92 children and adolescents who completed IFN-a therapy due to chronic HBV infection 1–13 years (mean 6 years) earlier were included in the study. A blood sample was collected from each child for biochemical (ALT) testing and serological markers of HBV infection, including HBV DNA levels (Cobas Amplicor HBV Monitor). HBV genotyping was performed in archive serum samples by a nested-multiplex-PCR.

Results: One to thirteen years after IFN-a therapy 77/92 (84%) patients were positive for HBsAg, but only 5 (5%) had detectable HBeAg. ALT levels ranged from 15 to 208 U/L (mean 45.7 U/L). HBV DNA testing was performed in 83 children, and 66 (80%) were found positive. HBV DNA levels ranged from <300 (10 patients) to >200,000 copies/mL (5 patients). HBeAg was detected only in children with high viraemia (>200,000 copies/mL). HBV genotypes were available in 49 patients, 41 (84%) of whom were infected with the genotype A, whereas the remaining 8 had the genotype D. There was no association between the viral genotype and either serological or biochemical parameters in the long post-interferon therapy follow-up.

Conclusions: The response to IFN treatment in children with chronic hepatitis B is not significantly influenced by HBV genotypes A or D, and the rate of serum HBV DNA clearance a few years after treatment remains low.