Management of Chronic HBV Infection in Children

Rukunuzzaman,; Benzamin, Md.; Sultana, Kaniz

doi:10.1007/978-3-319-93449-5_2

Cited by 2 publications

(4 citation statements)

References 22 publications

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“…Among the symptomatic patients anorexia/ Other presentations were jaundice, hepatomegaly and splenomegaly. These findings are similar to the findings of Rukunuzzaman et al 17 The present study revealed that most of the patient had normal biochemical profiles; raised serum ALT and serum AST were found in 36.4% and 32.7% of the cases; prothrombin time was prolonged in 5.5% of the patients; albumin and platelet count were low in 6% and 10.9% of the cases, respectively. These findings are similar to another study.…”

Section: Discussionsupporting

confidence: 92%

“…These findings are similar to another study. 17 One patient was severely anaemic while three patients were moderately anaemic. Similar findings were presented in another study.…”

Section: Discussionmentioning

confidence: 96%

“…This observation is similar to the finding of other studies. 17,18 However hepatitis B virus is a non cytopathic virus and does not cause direct injury to the hepatocyte. Here hepatocytic injury is caused by an activated immune system which takes course over a long period of time.…”

Section: Discussionmentioning

confidence: 99%

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Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Munmun,

Rukunuzzaman,

Mazumder

et al. 2023

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Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard, is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease. Objective To observe the role of transient elastography in the assessment of the progression of liver damage in children with chronic hepatitis B. Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings. Results The mean age was 11.46 (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively. Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like serum ALT, AST as well as virological parameters. Conclusion Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis. A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis.

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Section: Discussionsupporting

confidence: 92%

“…These findings are similar to another study. 17 One patient was severely anaemic while three patients were moderately anaemic. Similar findings were presented in another study.…”

Section: Discussionmentioning

confidence: 96%

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Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Munmun,

Rukunuzzaman,

Mazumder

et al. 2023

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“… 21 A parenteral injection, a family history of HCV infection, surgery, blood transfusions, and previous hospitalization were all listed as risk factors for HCV transmission in children in another research from Egypt. 22 …”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Risk Factors are Frequently Present in Children at Jinnah Postgraduate Medical Centre in Karachi

Kamani,

Butt,

Khemani

2024

Euroasian Journal of Hepato-Gastroenterology

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A bstract Background Infection with the hepatitis B virus (HBV) poses a serious threat to global public health. More than 300 million instances of chronic hepatitis are brought on by it, which is the primary cause of liver disease. This study was conducted to determine the risk factors of HBV in children at Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan. Materials and methods This cross-sectional study was conducted at the Department of Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan from January 2019 to April 2022. A total of 134 children aged below 16 years with HBV were recruited in this study. Demographic information was recorded. Screening for HBV was done in all patients. Investigations including liver biochemistry, hepatitis B surface antigen (HBsAg), and HBV DNA polymerase chain reaction (PCR) were conducted in the hospital along with a complete blood count and ultrasound whole abdomen. All information was collected on a predesigned proforma and evaluated using statistical package for the social sciences (SPSS), version 25.0, software. Results The mean age of patients was 11.02 ± 2.19 years. There were 57.46% males. The frequent risk factor was vertical transmission in 47% of children followed by blood transfusion in 23.9% of children, horizontal transmission in 13.4% of children, and prior history of surgical or dental intervention in 17.2% of children. Conclusion In this study, vertical transmission was the most common route of transmission of HBV. Additionally, 11% of family members were HBV positive. None had concomitant hepatitis C virus (HCV) and HDV infection. All pregnant females should be screened. Children on chronic blood transfusion therapy should be screened annually. Additionally, birth-dose HBV vaccination should be implemented as a key step in HBV prevention among Pakistani children. How to cite this article Butt N, Kamani L, Khemani H. Hepatitis B Risk Factors are Frequently Present in Children at Jinnah Postgraduate Medical Centre in Karachi. Euroasian J Hepato-Gastroenterol 2024;14(1):16–19.

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Management of Chronic HBV Infection in Children

Cited by 2 publications

References 22 publications

Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Hepatitis B Risk Factors are Frequently Present in Children at Jinnah Postgraduate Medical Centre in Karachi

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