Chronic hepatitis B virus (HBV) infection (CHB) in children remains a public health challenge despite significant success in programme is established to prevent mother‐to‐child transmission. In particular, CHB in Chinese children are mostly acquired through vertical transmission, which differs from the common infection route reported in other countries and regions. This situation has resulted in a high endemic prevalence of CHB in Chinese adults. Thus, successful treatment of children with CHB will prevent the development of advanced liver diseases in late adulthood. However, there is still no consensus on the clinical guideline to treat paediatric CHB. In this study, we evaluated the potential of interferon alpha (IFNa) treatment for Chinese children with CHB. A total of 41 patients with CHB aged 3‐17 years were enrolled in this retrospective study: 21 patients were treated with pegylated (PEG)‐IFNa and 20 patients without treatment served as the control group. The rates of HBV DNA suppression, hepatitis B e antigen (HBeAg) clearance and hepatitis B surface antigen (HBsAg) clearance were significantly higher in the PEG‐IFNa treatment group than in the control group (P < 0.05 at 48 weeks). Unexpectedly, PEG‐IFNa treatment achieved a high rate of HBsAb production, far exceeding the clinical outcome in documented PEG‐IFNa‐treated CHB adults. Further analysis revealed that younger children (3‐6 years old) were more responsive to PEG‐IFNa treatment with respect to achieving a protective level of HBsAb in a short treatment cycle than adolescents (10‐17 years old). Overall, these results indicate that the immune system of children might have a preserved PEG‐IFNa‐mediated mechanism to completely control HBV, which can help to design new strategies to treat CHB patients.

Background: Although the prevalence of hepatitis B in Guangzhou, China, is high, the epidemiological trends have not been well-documented. We analysed the data of newly reported hepatitis B cases in Guangzhou from 2006–2020, to explore the epidemiological trend and provide a scientific basis for the prevention and development of control measures.Methods: Information on the population and new cases of hepatitis B in Guangzhou from 2006–2020 was obtained from the China Information System for Disease Control and Prevention, which was used to calculate the annual notification rates of hepatitis B by gender, age group (0–9; 10–19; 20–59; ≥60), and location (urban or rural). The joinpoint regression analysis was used to analyse the time trends and calculate the average annual percentage change (AAPC) and annual percentage change (APC) for each identified trend line segment. Results: From 2006 to 2020, 361,909 new cases of hepatitis B were cumulatively reported. The average annual reporting rate was 189.64/100,000, and after a sharp increase from 2006–2008 (APC: 29.99%; 95% confidence interval [CI]: 12.14% to 50.67%), the notification rate showed a long-term downward trend from 2008–2018 (APC: -7.55%; 95% CI: -8.68% to -6.40%), with an average annual decrease of 1.27% (AAPC: -1.27%; 95% CI: -3.77% to 1.28%). Males had a significantly higher notification rate than females; however, the gender ratio decreased from a maximum of 2.53 in 2006 to a minimum of 1.54 in 2020. A downward trend in notification rate in urban areas and an upward trend in rural areas was observed, with an increase in the rural/urban ratio from 0.41 in 2006 to 1.57 in 2020. The notification rate for all age groups showed a downward trend year by year, except for the group ≥60 years, for whom it started to decrease from 2015. Conclusions: Although the overall notification rate of hepatitis B in Guangzhou was decreasing year by year, it was still high. Especially in rural areas, the notification rate has been increasing in recent years, and effective measures should be taken to control hepatitis B infection in Guangzhou.