New non-invasive serological and virological markers of hepatitis b virus (HBV) – can they help determine future chronic hepatitis b outcomes in children with perinatally acquired HBV infection?


Dr Ivana Carey of King’s College Hospital discusses her research and what it means for the future of treating childhood liver disease.

What is this study looking at?

Although the recently introduced general HBV vaccination in infancy, efficient screening during pregnancy and adequate management of pregnant HBV positive parents reduces the risk of transmission to the child there still remains a large cohort of paediatric patients contracting this persistent disease.

This study is focusing on the impact of HBV infection on liver disease progression and looking into its management to reduce progression to prevent further transmission.This study is investigating the new markers of HBV proteins (antigens) to monitor paediatric patients with chronic hepatitis b and whether this can predict the progression of liver disease in adolescence or young adulthood.

Translating genetic information of the virus into HBV proteins (antigens) were recently discovered and represent very useful non-invasive tool to monitor activity of HBV in blood without needing the liver sample.

The study aims to explore whether any of these markers of viral activity at diagnosis alone or in combination help to predict liver disease progression through enabling more precise diagnostics and whether this can assist in early intervention.

Why is this research important?

Chronic hepatitis b accounts for 1 million deaths yearly and it is a persistent disease contracted in childhood. Despite vaccination, passive immunisation and HBV treatment in pregnancy, 10% of infants of mothers with high viral load still get infected. Understanding the pathways involved in the viral control in children is important to prevent the progression of the disease and reduce the risk of having highly active disease during childbearing age.

What about the future?

If this study is successful it will lead to considering the setup of a national multicentre study focusing on this cohort of patients and their long-term management. This will have a further impact on reducing the risk of transmission and disease burden overall.

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