Dataset Information

Predictive factors of lamivudine treatment success in an hepatitis B virus-infected pediatric cohort: a 10-year study.

ABSTRACT:

Background

Hepatitis B virus (HBV) infections are responsible for the development of chronic hepatitis in 400 million people worldwide. Currently, no consensus exists as to when treatment should be initiated for pediatric patients.

Objectives

To evaluate the risks and predictive factors of success of lamivudine treatment in children with chronic, active HBV infection.

Methods

Forty-three children (22 male, median age 9.6 years) chronically infected with HBV and treated between 1998 and 2008 at CHU Ste-Justine (Montreal, Quebec) were included in the present chart review study. Inclusion criteria were detectable hepatitis B surface antigen and hepatitis B e antigen (HBeAg), minimum serum alanine aminotransferase (ALT) level of two times the upper limit of normal and detectable serum HBV DNA for at least three months. Patients received lamivudine for a minimum of six months (median 14 months). Genotyping was performed.

Results

Lamivudine treatment was effective in 35% of cases (15 of 43) and overall virological response (during or after treatment) was achieved in 51% of patients. Three patients harboured suspected lamivudine-resistant mutations and five progressed to HBeAg-chronic HBV. Predictive factors for success of treatment were: younger age at beginning of treatment (P=0.05), elevated ALT levels throughout treatment duration (P=0.003) and loss of HBeAg during treatment (P=0.016). Asian origin did not affect treatment success or spontaneous viral control during follow-up. HBV genotype did not influence treatment success.

Conclusions

Lamivudine treatment in a carefully selected cohort of HBV patients demonstrated a good rate of success and low incidence of mutation. Younger age at the beginning of treatment and high ALT levels during treatment predicted a positive outcome.

SUBMITTER: Yousef Y

PROVIDER: S-EPMC3395443 | biostudies-literature | 2012 Jul

REPOSITORIES: biostudies-literature

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Publications

Predictive factors of lamivudine treatment success in an hepatitis B virus-infected pediatric cohort: a 10-year study.

Yousef Yasmine Y Beland Kathie K Mas Emmanuel E Lapierre Pascal P Bouron Dal Soglio Dorothée D Alvarez Fernando F

Canadian journal of gastroenterology = Journal canadien de gastroenterologie 20120701 7

<h4>Background</h4>Hepatitis B virus (HBV) infections are responsible for the development of chronic hepatitis in 400 million people worldwide. Currently, no consensus exists as to when treatment should be initiated for pediatric patients.<h4>Objectives</h4>To evaluate the risks and predictive factors of success of lamivudine treatment in children with chronic, active HBV infection.<h4>Methods</h4>Forty-three children (22 male, median age 9.6 years) chronically infected with HBV and treated betw ...[more]

PMID: 22803017

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Project description:Objectives: Significant resources are devoted to neonatal prolonged mechanical ventilation (NPMV), but little is known about the outcomes in those children. Our primary objective was to describe the NPMV respiratory, digestive, and neurological outcomes at 18 months corrected age. Our second objective was on the early identification of which patients, among the NPMV cohort, will need to be ventilated for ≥125 days, which corresponded to the 75th percentile in the preliminary data, and to describe that subgroup. Methods: In this retrospective cohort study, we included all children born between 2004 and 2013 who had a NPMV (≥21 days of invasive or noninvasive respiratory support reached between 40 and 44 weeks of postconceptional age). We used random forests, logistic regression with penalization, naive Bayes, and XGBoost to predict which patients will need ≥125 days of ventilation. We used a Monte Carlo cross validation. Results: We included 164 patients. Of which, 40% (n = 66) were female, and the median gestational age was 29 weeks [interquartile range (IQR): 26-36 weeks] with a bimodal distribution. Median ventilation days were 104 (IQR: 66-139 days). The most frequently associated diagnoses were pulmonary hypertension (43%), early pulmonary dysplasia (41%), and lobar emphysema (37%). At 18 months corrected age, 29% (n = 47) had died, 59% (n = 97) were free of any respiratory support, and 45% (n = 74) were exclusively orally fed. A moderate area under the ROC curve of 0.65 (95% CI: 0.54-0.72) for identifying patients in need of ≥125 days of ventilation at inclusion was achieved by random forests classifiers. Among the 26 measured at inclusion, the most contributive ones were PCO2, inspired O2 concentration, and gestational age. At 18 months corrected age, patients ventilated for ≥125 days had a lower respiratory weaning success (76 vs. 87%, P = 0.05), lower exclusive oral feeding proportion (51 vs. 84%, P < 0.001), and a higher neurological impairment (median Pediatric Cerebral Performance Category score 3 vs. 2, P = 0.008) than patients ventilated for < 125 days. Conclusion: NPMV is a severe condition with a high risk of mortality, neurological impairment, and oral feed delay at 18 months. Most survivors are weaned of any respiratory support. We identified the risk factors that allow for the early identification of the most at-risk children of long-term ventilation with a moderate discrimination.

Dataset Information

Predictive factors of lamivudine treatment success in an hepatitis B virus-infected pediatric cohort: a 10-year study.

Background

Objectives

Methods

Results

Conclusions

Publications

Predictive factors of lamivudine treatment success in an hepatitis B virus-infected pediatric cohort: a 10-year study.

Similar Datasets

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