ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Chronic Hepatitis B: Long-term Follow-up Of 64 Children
Hasan Özen*, Nurten Koçak**, Aysel Yüce*, Figen Gürakan*,
Melda Çağlar***, Gülsev Kale***, Safiye Göğüş***
* Doç.Dr.,Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD, Gastroenteroloji Ünitesi,
** Prof.Dr.,Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD, Gastroenteroloji Ünitesi,
*** Prof.Dr.,Hacettepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD, Pediatrik Patoloji Ünitesi, ANKARA
Sixty-four children with hepatitis B surface antigen (HBsAg) at least for six months and with histologically confirmed chronic hepatitis were evaluated retrospectively between 1981 and 1996. Patients were examined regularly at least every six months. Liver function tests and markers of hepatitis B virus were also determined at each visit. Chronic persistent hepatitis (CPH) was diagnosed in 46 patients and chronic active hepatitis (CAH) in 18. Hepatomegaly and splenomegaly were the most frequent findings while only one-third of the patients had symptoms. Hepatitis B "e" antigen (HBeAg) was positive in 46 of 57 (%80.7) patients who were tested and it was more frequently positive in patients with CPH. There was no statistically significant difference regarding biochemical parameters between two groups, except for bilirubin concentrations. After a mean follow-up period of 43.5±30.5 months, HBeAg clearance was observed in 27% and in 22.2% of patients with CPH and CAH, respectively. All patients who had cleared HBeAg seroconverted to anti-HBe. HBsAg clearance was observed in only two patients with CPH. Second liver biopsy was performed in 16 patients. Progression to cirrhosis was observed in seven of 12 patients with CAH and in one of four patients with CPH. When the patients were evaluated for initial HBeAg status, total and conjugated bilirubin concentrations were higher in HBeAg negative patients. Clinical improvement was observed more frequently in patients who cleared HBeAg at the end of follow-up. In conclusion, chronic hepatitis B infection is not a benign disease and progression to cirrhosis may occur particularly in patients with CAH.
Keywords: chronic hepatitis B, chronic active hepatitis,
chronic persistent hepatitis
Turkiye Klinikleri J Med Sci 1998, 18:265-272
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