Effects of Endocrine on the Breakthrough of Immune-tolerant in Chronic Hepatitis B Virus Infected Children

Departments of Pediatrics, National Taiwan University Childrens Hospital, Taipei, Taiwan.

Corresponding Author: Jia-Feng Wu, MD. PhD, Departments of Pediatrics, National Taiwan University Childrens Hospital, No.8, Chung-Shan S.Rd, Taipei, Taiwan, Tel: (886-2)-23123456; E-Mail: [email protected]

Received Date: 18 Dec 2016   
Accepted Date: 27 Dec 2016   
Published Date: 29 Dec 2016

Copyright © 2016 Jia-Feng Wu

Citation: Jia-Feng Wu. (2016). Effects of Endocrine on the Breakthrough of Immune-tolerant in Chronic Hepatitis B Virus Infected Children. Mathews J Pediatr. 1(1): 006.

ABSTRACT

The hepatitis B virus (HBV) infection in endemic areas usually starts since infancy and early childhood and persists lifelong chronic infected status. The clinical course and severity varies among different chronic infected subjects, especially between different genders. Majority of chronic HBV infected children present with immune-tolerant status initially with normal liver profile, hepatitis Be antigen (HBeAg)-positive and high HBV viral load. They will then experience the immune clearance phase with various degree of liver injury at various age, and majority during or beyond puberty, and then enter the inactive phase after HBeAg seroconversion. 
The adrenarche and puberty onset modulate the start of immune clearance and the severity of liver inflammation in chronic HBV infected children. The sex steroid then acts differently on the host immune system, viral replication and even tumor suppressive genes. The difference between males and females are associated with different risk of HBeAg-negative hepatitis, liver cirrhosis, and even the occurrence of hepatocellular carcinoma in later life. Early events in childhood during chronic HBV infection may serve as important predictors for the later outcoms in adulthood. Understanding the mechanisms triggering liver inflammation and their long-term impacts may enhance the development of better and earlier therapeutic strategies for patients with chronic HBV infection.

KEYWORDS

Adrenarche; Hepatitis B Virus; Immune-Tolerant; Immune Clearance; Menarche; Puberty; Endocrine System.

ABBREVIATIONS

Alanine aminotransferase, ALT; deoxyribonucleic acid, DNA; dehydroepiandrosterone sulphate, DHEAS; hepatitis B virus, HBV; hepatitis B surface antigen, HBsAg; hepatitis B e antigen, HBeAg; hepatitis B core antigen, HBcAg; hepatitis B X protein, HBx; hepatocellular carcinoma, HCC