Tenofovir Disoproxil Fumarate Treatment for Pediatric Patients with Perinatally Acquired Chronic Hepatitis B

Abstract

Objectives: Infection with Hepatitis B Virus (HBV) is an important cause of chronic liver disease in children. Perinatal transmission accounts for the majority of infections. We examined the effects of Tenofovir Disoproxil Fumarate (TDF) on pediatric patients with perinatally acquired Chronic Hepatitis B (CHB).
Methods: We retrospectively analyzed the data on pediatric patients with perinatally acquired CHB treated with TDF over a 72-week period.
Results: 55 cases were analyzed of which 26 were treated. Fourteen (54%) had immune active hepatitis and 12(46%) were in the immune tolerant phase. In both groups, no difference in inflammation or fibrosis was found on baseline liver biopsy. Mean HBV DNA level at baseline was 9 log10 copies/mL. Levels declined to 5.9 log10 copies/mL at 40 weeks of therapy and were undetectable in 19/26(73%) of the patients by week 72. Alanine aminotransferase (ALT) levels normalized by 32 weeks in the immune active hepatitis group. No breakthrough elevations were seen in either group. Overall, 11(42%) and 9(35%) of the patients had Hepatitis B e anti gen (HBeAg) clearance and Hepatitis B e antibody (anti-HBe) seroconversion respectively by 72 weeks of treatment.
Conclusion: TDF is an effective therapy in pediatric patients with perinatally acquired CHB in both immune active hepatitis and immune tolerant phase patients. Response to treatment did not seem to be affected by baseline ALT levels and liver histopathology findings.