China News Service, Shenzhen, October 26. The kick-off meeting of the Antiviral Treatment Research (Sprouting) Project for Children with Chronic Hepatitis B was held in Shenzhen recently.

The reporter learned from the meeting that there are about 70 million cases of chronic hepatitis B virus infection in China, of which nearly 2 million children are positive for hepatitis B surface antigen.

However, at present, there is a relatively lack of specialist teams in the diagnosis and treatment of chronic hepatitis B in children in China, and there are problems such as insufficient understanding and lack of clinical guidelines, which have brought many confusions to children, families and society.

　　In order to accumulate evidence-based medical evidence for antiviral treatment of children with chronic hepatitis B, and to standardize the path of diagnosis and treatment of children with chronic hepatitis B in China, the Beijing Chen Jumei Charity Foundation initiated the "Sprout" project.

The project is led by the Shenzhen Third People's Hospital, and the Chinese Medical Education Association Liver Disease Committee and the Children's Liver Disease Cooperation Group (preparation) of the Chinese Medical Association Liver Disease Branch are the academic guides.

Chronic hepatitis B occupies the first place in childhood liver diseases in China

　　The epidemiological survey results in 2014 showed that the carrying rate of hepatitis B surface antigen in children aged 5 to 14 in China has dropped to 0.94%, and the carrying rate of children aged 1 to 4 is only 0.32%.

Even so, due to the large population of our country, there are still nearly 2 million children who are positive for hepatitis B surface antigen and need to receive professional diagnosis and treatment.

　　Among the causes of childhood liver disease in China, chronic hepatitis B is the first.

After a child is infected with hepatitis B virus, some of the children will progress to the disease, and some may even develop cirrhosis and liver cancer. It has been reported that the fetus with intrauterine infection has developed liver cirrhosis.

Among children with liver cancer in China, hepatitis B virus infection accounts for the first place, as high as 34% to 95%.

In recent years, with the control and disappearance of the hepatitis C virus, this proportion has shown an upward trend.

Professor Zhang Hongfei, Beijing Tsinghua Chang Gung Memorial Hospital, Affiliated to Tsinghua University.

Photo courtesy of the organizer of the kick-off meeting

　　Zhang Hongfei, a professor at Beijing Tsinghua Chang Gung Memorial Hospital affiliated to Tsinghua University, pointed out that if patients with hepatitis B virus infection undergo hepatitis B surface antigen seroconversion before they develop cirrhosis and liver cancer, the long-term prognosis will be very good.

However, if Chinese childhood hepatitis B does not interfere with treatment, the probability that hepatitis B surface antigen disappears spontaneously and turns into hepatitis B virus antibody positive is only 0.6% to 1% per year; the seroconversion rate of hepatitis B E antigen in children is also very low. , European data show that the annual probability of hepatitis B E antigen seroconversion in children under 3 years old is less than 2%, and that in children over 3 years old is 4% to 5%. Most of them eventually develop into adult chronic hepatitis B.

　　If chronic hepatitis B in children is not treated in time, it will not only affect the health of childhood, but also become a huge reserve population of adult hepatitis B in China.

The majority of adult chronic hepatitis B virus carriers and adult liver cancer in China originate from childhood hepatitis B virus infection.

Chronic hepatitis B in children can be cured, but the treatment is not standardized

　　At present, there is a relatively lack of specialized teams in the diagnosis and treatment of children with chronic hepatitis B in China. Pediatricians and hepatologists have insufficient experience in diagnosis and treatment of children with hepatitis B, and lack standard professional guidance.

At the same time, because most of the children infected with hepatitis B virus in infants and young children have no obvious clinical manifestations, and even alanine aminotransferase is still normal during active inflammation, and does not affect their growth and development, many people think that hepatitis B is in children and adolescents. The period is a relatively benign process, without treatment, which delays the timing of treatment.

　　On the other hand, doctors have insufficient understanding of the timing and efficacy of antiviral treatment for children with chronic hepatitis B.

For children with hepatitis B, many people still maintain an inherently outdated concept that children with hepatitis B are refractory, and that children are young, have poor tolerance to drugs, and are prone to adverse reactions and drug resistance; in addition, at present The overall treatment effect is limited and clinical data is lacking. As a result, the antiviral treatment plan for children is still very conservative, which brings a lot of confusion and adverse consequences to children, families and society.

　　With the Chinese government's emphasis on national health and the continuous efforts and explorations of Chinese experts, many breakthroughs have been made in the treatment of children with chronic hepatitis B.

Many expert studies have found that children with chronic hepatitis B can be cured clinically, and the clinical cure rate can reach 10% to 40%.

At the same time, compliance is better, adverse reactions are relatively fewer than adults, and the younger the age, the better the treatment effect. Therefore, children with chronic hepatitis B should be diagnosed and treated as needed, treated as soon as possible, and benefited early.

Protect the health of children with chronic hepatitis B, eliminate the virus in its bud

　　In order to accumulate real-world research evidence of antiviral treatment for children with chronic hepatitis B and provide a basis for standardizing the diagnosis and treatment of children with chronic hepatitis B in China, the Beijing Chen Jumei Charity Foundation launched the "Children's Chronic Hepatitis B Antiviral Treatment Research (Sprouting) Project" ".

　　It is reported that this is the first large-scale real-world study on the antiviral treatment of children with chronic hepatitis B in China. Through the implementation of the project, there are no less than 30 hospitals relying on the development of the Shenzhen Third People’s Hospital; the enrollment age is 3 to 18 1900 cases of children with chronic hepatitis B were treated with ETV monotherapy, ETV combined with PEGIFNα2b, and ETV combined with PEGIFNα2b pulse therapy to explore the optimal antiviral treatment plan for children with chronic hepatitis B, and observe the nucleoside drug list. The efficacy and safety of pegylated interferon alpha combined with nucleoside drugs in the treatment of children with chronic hepatitis B.

　　At present, domestic and international guidelines for the treatment of chronic hepatitis B are mainly aimed at adults.

In China, a very important reason for the irregular diagnosis and treatment of children with chronic hepatitis B is that there are no guidelines and treatment standards for children with hepatitis B, and there is no reliable basis for doctors to make decisions.

　　The implementation of the "Sprout" project, on the one hand, can benefit children through real-world research while obtaining reliable and large-sample real-world research data, providing a basis for the treatment of children with chronic hepatitis B in China and even the formulation of guidelines; on the other hand; It is also launching antiviral treatment classes for children nationwide to train a team of doctors who specialize in antiviral treatment of children with chronic hepatitis B, so that Chinese children with chronic hepatitis B can get rid of the troubles of the disease as soon as possible.

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