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Natural history of chronic hepatitis B virus infection in children in Japan: a comparison of mother-to-child transmission with horizontal transmission

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

It is necessary to evaluate the natural history of children with hepatitis B virus (HBV) infection in each country to consider their long-term management.

Methods

A multi-center observational study of children with chronic HBV infection who were diagnosed at age ≤15 years was carried out in 18 hospitals in Japan.

Results

We reviewed children with HBV infection including 381 with mother-to-child transmission (MTCT) and 154 with horizontal transmission, genotype C being the most prevalent virus genotype (83%). Children with horizontal transmission were more frequently infected with HBV genotype A or B and more likely to receive interferon therapy than those infected by MTCT. The HBeAg seroconversion rate at 15 years of age was 42% in the MTCT group and 38% in the horizontal group. It was lower in children with genotype C infection than in those infected with other genotypes (33 versus 45%). Hepatitis developed at any age but before 4 years of age the incidence was high in the horizontal group. At 3 years after the onset of the hepatitis, 26% of children with MTCT and 30% of those with horizontal transmission became inactive carriers. The incidences of hepatocellular carcinoma (HCC) at 30 years of age were 6% in the MTCT group and 11% in the horizontal group.

Conclusions

Patients with childhood-onset HBV infection with MTCT and horizontal transmission developed hepatitis and seroconverted to anti-HBe at any age and had a lifetime risk of developing HCC.

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Acknowledgements

This study was supported by a grant-in-aid for hepatitis research from the Ministry of Health, Labor and Welfare of Japan and Japan Agency for Medical Research and Development.

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Authors and Affiliations

  1. Department of Pediatrics, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-ku, Osaka, 558-8558, Japan

    Tomoko Takano & Hitoshi Tajiri

  2. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Satoyo Hosono

  3. Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital, Yokohama, Japan

    Ayano Inui

  4. Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Tottori, Japan

    Jun Murakami

  5. Department of Pediatrics, Kurume University Medical Center, Kurume, Japan

    Kosuke Ushijima

  6. Department of Pediatrics, Osaka University Hospital, Suita, Japan

    Yoko Miyoshi

  7. Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan

    Yuri Etani

  8. Department of General Pediatrics, Miyagi Children’s Hospital, Sendai, Japan

    Daiki Abukawa

  9. Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan

    Mitsuyoshi Suzuki

  10. Department of Microbiology/Immunology, State University of New York at Buffalo, Buffalo, USA

    Stephen Brooks

Authors
  1. Tomoko Takano
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  2. Hitoshi Tajiri
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  3. Satoyo Hosono
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  4. Ayano Inui
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  5. Jun Murakami
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  6. Kosuke Ushijima
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  7. Yoko Miyoshi
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  8. Yuri Etani
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  9. Daiki Abukawa
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  10. Mitsuyoshi Suzuki
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  11. Stephen Brooks
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Corresponding author

Correspondence to Tomoko Takano.

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Conflict of interest

Ayano Inui received lecture fees from MSD and Astellas.

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Takano, T., Tajiri, H., Hosono, S. et al. Natural history of chronic hepatitis B virus infection in children in Japan: a comparison of mother-to-child transmission with horizontal transmission. J Gastroenterol 52, 1041–1050 (2017). https://doi.org/10.1007/s00535-017-1315-4

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  • DOI: https://doi.org/10.1007/s00535-017-1315-4

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