Entecavir treatment of children 2–16 years of age with chronic hepatitis B infection

Background and study aimsChildhood acquired chronic hepatitis B is associated with a significant lifetime risk of developing cirrhosis or hepatocellular carcinoma. Our objective in this study was to report retrospectively the response to treatment with Entecavir in 8 children with chronic hepatitis B followed at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia.Patients and methodsThis study is an observational hospital based chart review of children and adolescents with chronic hepatitis B treated with entecavir at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia in the period between June 2007 and July 2011.ResultsHalf of the studied group was males, and the median age at the time of treatment was 4.8 years (range, 2.6–15). All subjects displayed infection with HBV genotype D and all were HBeAg positive. Half of the patients had been previously treated with lamivudine, while the remaining half was treatment naïve patients. The mean ALT ± SD was 84.9 ± 34.7 IU/L (range, 46–133) and the mean HBV DNA was 5.01 × 108 ± 5.7 × 108 IU/mL (range, 5.5 × 107–1.3 × 109). Patients were treated with a daily oral dose of 0.5 mg entecavir, and the mean duration of treatment was 23.8 ± 11.9 months, (range 14.9–44.7 months). HBV DNA suppression of more than 2 log10 was achieved in all patients. HBV DNA was undetected in 37.5%, with ALT normalization in 87.5% and lastly HBeAg seroconversion and loss occurred in 37.5%. No adverse side effects were observed during the treatment with entecavir.ConclusionWe conclude from this limited data that 37.5% of children treated with entecavir achieved HBeAg loss and seroconversion with no side effects observed during treatment period, however long term safety and efficacy in children should be demonstrated through a multicenter study, enrolling large number of patients.