Antiviral treatment is beneficial and often well tolerated in children with chronic hepatitis B virus (HBV) infection in the immune-tolerant phase, according to the results of a systematic review and meta-analysis.
The team of researchers searched multiple databases (such as PubMed, Embase, Cochrane, Web of Science, CBM, CNKI, and Wanfang Data) for clinical trials evaluating the efficacy and safety of antiviral treatments in children (1-18 years old). Immune tolerance to hepatitis B virus infection from onset to February 2023. They calculated the results separately for single-arm studies and controlled studies.
A total of nine trials (two randomized controlled trials (RCTs), three non-RCTs, and four single-arm studies) involving 442 patients met the eligibility criteria.
Results from randomized controlled trials showed that antiviral treatment resulted in higher HBsAg loss (risk ratio (RR), 6.11, 95% confidence interval (CI), 1.67-22.31; p=0.006) and HBsAg serological response (RR, 5.29 , 95%) and HBeAg disappearance (RR, 3.00, 95% CI, 1.35-6.66; p=0.007) compared with controls at the end of follow-up, CI, 1.47-19.07; p=0.011).
In single-arm studies, the pooled incidence of HBsAg loss with antiviral therapy was 24% (95% CI, -0.1 to 48) and the pooled incidence of HBeAg loss was 24% (95% CI, -0.1 to 48). The pooled incidence of HBeAg loss was 24% (95% CI, -0.1 to 48). Percent HBsAg seroconversion CI, −5 to 52).
“Due to the limited quality and quantity of included studies, more high-quality studies are needed to validate our findings,” the researchers said.