探讨慢性乙型肝炎患儿抗病毒治疗的短期疗效。

回顾性分析2019年3月至2019年12月符合入组标准的6例慢性乙型肝炎儿童的临床资料、抗病毒治疗24周的疗效及不良反应。

6例患儿中男性2例，女性4例，确诊年龄1岁4月至9岁4月。5例患儿母亲乙型肝炎病毒表面抗原（HBsAg）阳性，1例患儿父亲HBsAg阳性，且均为乙型肝炎病毒e抗原（HBeAg）阳性患者。疗效：6例患儿治疗24周时4例丙氨酸氨基转移酶（ALT）恢复正常，2例ALT维持在较低水平波动；4例患儿治疗24周时HBV DNA低于检测下限，2例HBV DNA载量显著降低，分别为2.31 × 10³IU/ml和1.96 × 10²IU/ml。治疗24周时1例患者HBeAg转阴，1例患者实现HBeAg血清学转换；3例HBsAg转阴，其中1例抗-HBs阳性，但HBeAg仍阳性；2例HBsAg迅速下降，分别为55.35 IU/ml和35.45 IU/ml。1例9岁4个月HBeAg阴性CHB患儿ALT恢复正常，HBV DNA低于检测下限，HBsAg定量仍较高，为9 875 IU/ml。不良反应：轻度流感样症状者4例，发热者4例，轻度乏力者3例，食欲下降4例；血常规中白细胞及中性粒细胞下降，未予特殊干预自行恢复；4例患者治疗初期ALT一过性增高，多为轻度升高；无皮疹、脱发、甲状腺功能亢进或减退病例。

CHB儿童患者抗病毒治疗效果显著，不良反应少，对于有治疗指征者建议尽早开始抗病毒治疗。

To investigate the short-term efficacy of antiviral therapy for children with chronic hepatitis B (CHB).

The clinical data, short-term efficacy and adverse reactions of antiviral therapy for 24 weeks of 6 children who met inclusion criteria from March 2019 to December 2019 were analyzed, retrospectively.

Among the 6 cases, 2 cases were male and 4 cases were female, the diagnosis age was 1 year 4 months to 9 years 4 months. Total of 5 cases had HBsAg positive mothers and 1 case had HBsAg positive father, all with HBeAg positive. Treatment effect: after 24 weeks of treatment, 4 cases with alanine aminotransferase (ALT) returned to normal, and 2 cases with ALT remained at a low level. After 24 weeks of treatment, HBV DNA of 4 cases were lower than the detection limit, and HBV DNA of 2 cases reduced significantly (2.31 × 10³ IU/ml and 1.96 × 10² IU/ml). After 24 weeks of treatment, 1 case had HBeAg negative conversion and 1 case had HBeAg serological conversion. Total of 3 cases had HBsAg clearance, among whom, 1 case had HBsAg seroconversion with anti-HBs, but HBeAg was positive. HBsAg decreased significantly in 2 cases (55.35 IU/ml and 35.45 IU/ml). For the 9 years 4 months case with HBeAg negative, ALT returned to normal, HBV DNA was lower than detection limit, while HBsAg was still high (9 875 IU/ml). Adverse reactions: 4 cases had mild influenza-like symptoms, 4 cases had fever, 3 cases had mild fatigue and 4 cases had decreased appetite. Leukocytes and neutrophils were decreased and returned to normal without special intervention. At the beginning of treatment, 4 cases had transient elevation of ALT, most of them were slightly elevated. There was no case with rash, hair loss, hyperthyroidism or hypothyroidism.

Antiviral therapy for children with CHB had good efficacy and few adverse reactions. Early initiation of antiviral therapy was recommended for those with indications of treatment.