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Seroconversion of Hepatitis B Virus Surface Antigen in Chronic Hepatitis B Child Treated with Entecavir

Medknow Publications & Media Pvt Ltd
Publication Date
DOI: 10.4103/1947-2714.100996
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Sir, Hepatitis B virus (HBV) infection in children possesses a higher rate of progression to chronic hepatitis, however, a consensus guideline for treatment has not been established so far.[12] Entecavir as carbocyclic analog with inhibition of HBV replication[3] is shown encouraging effects in control of chronic HBV infection.[3] In the present article, we present seroconversion of hepatitis B virus surface antigen (HBsAg) by entecavir administrated in a young child with chronic hepatitis B. A 4-year-old girl was presented in a history of chronic HBV infection for 2 years. The perinatal history indicated that her mother was a HBV carrier, and grandmother died of cirrhosis due to chronic hepatitis B. The patient was vaginally born, and was immunized with hepatitis B vaccine and high-titter immunoglobulin against HBV at birth. During past 2 years, the patient had been administrated with Chinese herbal medicines. Because of unsatisfying theroputic effect, the patient was then transferred to our department. On admission, abdominal computed tomography (CT) scan demonstrated a normal size of the liver, but the spleen was enlarged in size. The laboratory tests showed that alanine aminotransferase (ALT) 92 U/L, aspartate transaminase (AST) 96 U/L, γ-glutamyl transpeptadase (GGT) 8 U/L, HBsAg positive, HBeAg positive, anti-HBV core antibody positive, and HBV DNA level 2.703 × 107 copies/mL. The autoimmune antibodies were absent, and serum markers for hepatitis A virus, hepatitis C virus, hepatitis E virus, cytomegalovirus, and Epstein Bar virus were negative. The patient was diagnosed with chronic hepatitis B with positive HBsAg. After informed consent was obtained from her parents, the patient was started with oral administration of entecavir at dose of 0.16 mg once a day. During administration of entecavir, the patient was regularly monitored by tests of liver function, HBsAg and HBV DNA level, and hematologic system. Tests showed that ALT was declined 2 weeks after entecavir administrator, and was

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