HBeAg seroconversion in children infected during early childhood with hepatitis B virus.

Background: Seroconversion of hepatitis B e-antigen (HBeAg) to anti-HBe is associated with lower viral load and liver diseases.

Objectives: The purpose of this study was to assess the seroconversion rate of HBeAg to anti-HBe in children who acquired hepatitis B virus (HBV) infection during early childhood.

Study Design: From September 1990 to December 2010, 139 HBeAg-positive children were followed up. Eighty-one subjects were of failure of hepatitis B immune globulin (HBIG) and hepatitis B vaccine at birth and 58 children <10 years of age who were born before 1990 did not receive HBIG and hepatitis B vaccine. HBsAg, HBeAg, anti-HBs and anti-HBe were assessed every 6 months.

Results: Sixty-two (44.6%) cases were males and 77 (55.4%) were females. The mean duration of follow-up was 18 ± 6.6 years. Twenty-four (17.3%) mothers were HBeAg positive and 115 (82.7%) were anti-HBe positive. Eighty-two (59%) children became anti-HBe positive. The seroconversion rates in the first, second and third decades were 25%, 63.4% and 70.5%, respectively (p<0.001). The children of anti-HBe-positive mothers had a higher seroconversion rate than the HBeAg-positive mothers (75% vs. 33.9%, p<0.0001). Time to seroconversion in children born to HBeAg-positive mothers was similar to those born to anti-HBe positive mothers (hazard ratio (HR)=1.03, p=0.973). Time to seroconversion in children who received hepatitis B vaccine and HBIG was shorter than those who did not (HR=6.35, p<0001).

Conclusions: HBeAg seroconversion in the second and the third decades was higher than that in the first decade. Children born to anti-HBeAg-positive mothers and those who received HBIG and hepatitis B vaccine had higher seroconversion rates.