• Register
Forgot Password

If you have forgotten your password you can enter your email here and get a temporary password sent to your email.


Leaving Community

Are you sure you want to leave this community? Leaving the community will revoke any permissions you have been granted in this community.


Long-term follow-up of children with postnatal immunoprophylaxis failure who were infected with hepatitis B virus surface antigen gene mutant.

BACKGROUND: The long-term evolution and outcomes of infection with a hepatitis B virus (HBV) surface antigen (HBsAg) gene mutant (hereafter, "HBsAg-mutant HBV") among immunized children remain unclear. METHODS: Ninety-five HBsAg-positive children aged 0.5-18.4 years (mean age, 5.8 years) who did not respond to postnatal immunoprophylaxis were prospectively followed for 1-22.8 years (mean follow-up, 8.5 years). Clinical, serologic, and virologic features were compared between 38 untreated HBV e antigen (HBeAg)-positive children carrying HBsAg-mutant HBV (group 1) and 49 children carrying wild-type HBV (group 2). HBsAg-mutant HBV was examined in 20 immunized children presenting with HBV-related hepatocellular carcinoma (HCC). RESULTS: The initial alanine aminotransferase (ALT) level, the maximal ALT level during the HBeAg-positive phase of HBV infection, the cumulative incidence of HBeAg seroconversion (P = .0018), and the rate of low serum HBV DNA load (defined as <10 copies/mL) at the last visit (P = .006) were higher in group 1 than in group 2. A higher frequency of HBV genotype C and a higher ALT level during surface mutant viremia were observed in codon 110-129 mutants than in codon 144-145 mutants. None of the 95 patients developed cirrhosis or HCC. HBsAg-mutant HBV was detected in 3 of 8 (38%) HBV DNA-positive children with HCC. CONCLUSIONS: HBeAg-positive immunized children carrying HBsAg-mutant HBV may develop hepatitis activity, HBeAg seroconversion, and a low viremic state earlier than those carrying wild-type HBV. Continuous monitoring of children with wild-type HBV infection and those with HBsAg-mutant HBV for possible development of HCC is needed.

Pubmed ID: 23300165


  • Hsu HY
  • Chang MH
  • Ni YH
  • Jeng YM
  • Chiang CL
  • Chen HL
  • Wu JF
  • Chen PJ


The Journal of infectious diseases

Publication Data

April 28, 2013

Associated Grants


Mesh Terms

  • Adolescent
  • Alanine Transaminase
  • Carcinoma, Hepatocellular
  • Child
  • Child, Preschool
  • Codon
  • DNA, Viral
  • Evolution, Molecular
  • Follow-Up Studies
  • Genes, Viral
  • Genotype
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines
  • Hepatitis B e Antigens
  • Hepatitis B virus
  • Hepatitis B, Chronic
  • Humans
  • Immunization
  • Incidence
  • Infant
  • Liver Neoplasms
  • Longitudinal Studies
  • Prospective Studies
  • Time Factors
  • Treatment Failure
  • Viral Load
  • Viremia