Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2015; 21(7): 2073-2079
Published online Feb 21, 2015. doi: 10.3748/wjg.v21.i7.2073
Chronic hepatitis B in children with or without malignancies: A 13-year follow-up
Merve Usta, Nafiye Urgancı, Zeynep Yıldız Yıldırmak, Sema Dogan Vural
Merve Usta, Nafiye Urgancı, Department of Pediatric Gastroenterology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul 34377, Turkey
Zeynep Yıldız Yıldırmak, Department of Pediatric Haematology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul 34377, Turkey
Sema Dogan Vural, Department of Pediatric Oncology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul 34377, Turkey
Author contributions: Usta M, Urgancı N, Yıldırmak ZY and Dogan Vural S contributed equally to this work; Usta M, Urgancı N, Yıldırmak ZY and Dogan Vural S designed the research; Usta M and Urgancı N performed the research, contributed new reagents/analytic tools and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Merve Usta, MD, Department of Pediatric Gastroenterology, Sisli Hamidiye Etfal Education and Research Hospital, Sisli, Istanbul 34377, Turkey. mervekesim@yahoo.com
Telephone: +90-532-3439455 Fax: +90-212-2240772
Received: July 11, 2014
Peer-review started: July 17, 2014
First decision: August 6, 2014
Revised: September 3, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: February 21, 2015
Processing time: 214 Days and 18 Hours
Abstract

AIM: To evaluate the outcome of chronic hepatitis B (CHB) in children with or without malignancies.

METHODS: Twenty four children (15 boys and 9 girls) with malignancies, followed up by the pediatric gastroenterology outpatient clinic for CHB between January 2000 and December 2013, were enrolled in the study (Group 1). Group 2 was formed with twenty five children (11 girls and 14 boys) diagnosed with CHB without malignancies. The data from the patients’ records were compared between the two groups.

RESULTS: Hepatitis B e antigen (HBeAg)/antiHBe seroconversion was observed in 3 patients (12.5%) in group 1 and 15 patients (60%) in group 2, with annual seroconversion rates of 1.61% and 16.6%, respectively, and the difference was significant (P < 0.01). One patient (6.6%) in Group 1 and 9 patients (53%) in Group 2 showed HBeAg/antiHBe seroconversion after treatment and the difference between the two groups was significant (P < 0.06) Loss of hepatitis B surface antigen was observed in one patient in each of group 1 and 2. No clinical, laboratory and imaging findings of liver disease were observed in any of the patients at the end of the study.

CONCLUSION: HBeAg/antiHBe seroconversion rate was lower in patients who had recovered from cancer.

Keywords: Chronic hepatitis B, Children, Pediatric malignancies, Seroconversion, Course of the disease

Core tip: Children with hematological cancers have a high risk for hepatitis B virus infection due to immunosuppression secondary to chemotherapy, radiotherapy and multiple blood transfusions. Although there are some studies in the literature addressing the course of chronic hepatitis B (CHB), few studies were conducted on patients with CHB who have been treated for cancer. The aim of our study is to evaluate the clinical characteristics and the course of CHB in a cohort consisting of Turkish children with CHB who had received pediatric cancer therapy and compare the results with children diagnosed with CHB who do not have cancer.