Tenofovir Disoproxil Fumarate Treatment for Pediatric Patients with Perinatally Acquired Chronic Hepatitis B

Abstract

Objectives: Infection with Hepatitis B Virus (HBV) is an important cause of chronic liver disease
in children. Perinatal transmission accounts for the majority of infections. We examined
the effects of Tenofovir Disoproxil Fumarate (TDF) on pediatric patients with perinatally acquired
Chronic Hepatitis B (CHB).
Methods: We retrospectively analyzed the data on pediatric patients with perinatally acquired
CHB treated with TDF over a 72-week period.
Results: 55 cases were analyzed of which 26 were treated. Fourteen (54%) had immune active
hepatitis and 12(46%) were in the immune tolerant phase. In both groups, no difference in
inflammation or fibrosis was found on baseline liver biopsy. Mean HBV DNA level at baseline
was 9 log10 copies/mL. Levels declined to 5.9 log10 copies/mL at 40 weeks of therapy and were
undetectable in 19/26(73%) of the patients by week 72. Alanine aminotransferase (ALT) levels
normalized by 32 weeks in the immune active hepatitis group. No breakthrough elevations
were seen in either group. Overall, 11(42%) and 9(35%) of the patients had Hepatitis B e antigen
(HBeAg) clearance and Hepatitis B e antibody (anti-HBe) seroconversion respectively by
72 weeks of treatment.
Conclusion: TDF is an effective therapy in pediatric patients with perinatally acquired CHB in
both immune active hepatitis and immune tolerant phase patients. Response to treatment did
not seem to be affected by baseline ALT levels and liver histopathology findings.