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Spontaneous loss of chronic HBV infection markers in treatment-naïve children: a systematic review and pooled meta-analyses
Expert Review of Anti-infective Therapy ( IF 5.7 ) Pub Date : 2020-11-23 , DOI: 10.1080/14787210.2021.1845652
Yuting Yang 1 , Ailong Huang 2 , Yao Zhao 1
Affiliation  

ABSTRACT

Objectives: Chronicity could be a serious threat to hepatitis B virus (HBV)-infected children. The necessity of antiviral treatment to HBV-infected children has caused much controversy. The authors aimed to conduct a systematic review and meta-analysis of synthesized evidence regarding the spontaneous loss of chronic HBV infection markers in treatment-naïve children for exploring their long-term management.

Methods: Observational cohort studies and non-treatment arms of randomized controlled trials were searched that reported the spontaneous loss of chronic HBV infection markers in untreated children (characterized by the presence of HBsAg ≥6-month), via the rates of hepatitis B surface antigen (HBsAg) loss, hepatitis B e antigen (HBeAg) seroconversion, and HBV DNA suppression with random-effects model.

Results: Of 7,427 studies screened, 20 were included in meta-analysis. With cumulative 23,153 person-years of follow-up, the pooled annual incidences of HBsAg and HBeAg loss, HBV DNA suppression were 1, 6, 7%, respectively. Rates within HBeAg loss and HBV DNA suppression did differ by the transmission modes and ALT levels, not in HBsAg.

Conclusion: Spontaneous HBsAg loss (function cure) occurs infrequently in treatment-naïve children with chronic HBV infection. Design of practically applicable programs aiming at therapeutics of children may be necessary to support the goal of eliminating HBV infection worldwide.



中文翻译:

初治儿童慢性 HBV 感染标志物的自发丢失:系统评价和汇总荟萃分析

摘要

目的:慢性可能是对乙型肝炎病毒 (HBV) 感染儿童的严重威胁。HBV感染儿童抗病毒治疗的必要性引起了很多争议。作者旨在对有关初治儿童慢性 HBV 感染标志物自发丢失的综合证据进行系统评价和荟萃分析,以探索他们的长期管理。

方法:通过乙型肝炎表面抗原的比率,搜索了观察性队列研究和随机对照试验的非治疗组,这些研究报告了未经治疗的儿童(以存在 HBsAg ≥6 个月为特征)慢性 HBV 感染标志物的自发丢失(HBsAg) 丢失、乙型肝炎 e 抗原 (HBeAg) 血清转换和 HBV DNA 抑制与随机效应模型。

结果:在筛选的 7,427 项研究中,20 项被纳入荟萃分析。在累计 23,153 人年的随访中,HBsAg 和 HBeAg 消失、HBV DNA 抑制的合并年发生率分别为 1%、6%、7%。HBeAg 消失率和 HBV DNA 抑制率确实因传播方式和 ALT 水平而异,而不是 HBsAg。

结论: HBsAg 自发消失(功能治愈)很少发生在未接受治疗的慢性 HBV 感染儿童中。可能有必要设计针对儿童治疗的切实可行的计划,以支持在全球范围内消除 HBV 感染的目标。

更新日期:2020-11-23
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