HBeAg seroconversion in children infected during early childhood with hepatitis B virus.

BACKGROUND: Seroconversion of hepatitis B e-antigen (HBeAg) to anti-HBe is associated with lower viral load and liver diseases. OBJECTIVES: The purpose of this study was to assess the seroconversion rate of HBeAg to anti-HBe in children who acquired hepatitis B virus (HBV) infection during early childhood. STUDY DESIGN: From September 1990 to December 2010, 139 HBeAg-positive children were followed up. Eighty-one subjects were of failure of hepatitis B immune globulin (HBIG) and hepatitis B vaccine at birth and 58 children <10 years of age who were born before 1990 did not receive HBIG and hepatitis B vaccine. HBsAg, HBeAg, anti-HBs and anti-HBe were assessed every 6 months. RESULTS: Sixty-two (44.6%) cases were males and 77 (55.4%) were females. The mean duration of follow-up was 18 ± 6.6 years. Twenty-four (17.3%) mothers were HBeAg positive and 115 (82.7%) were anti-HBe positive. Eighty-two (59%) children became anti-HBe positive. The seroconversion rates in the first, second and third decades were 25%, 63.4% and 70.5%, respectively (p<0.001). The children of anti-HBe-positive mothers had a higher seroconversion rate than the HBeAg-positive mothers (75% vs. 33.9%, p<0.0001). Time to seroconversion in children born to HBeAg-positive mothers was similar to those born to anti-HBe positive mothers (hazard ratio (HR)=1.03, p=0.973). Time to seroconversion in children who received hepatitis B vaccine and HBIG was shorter than those who did not (HR=6.35, p<0001). CONCLUSIONS: HBeAg seroconversion in the second and the third decades was higher than that in the first decade. Children born to anti-HBeAg-positive mothers and those who received HBIG and hepatitis B vaccine had higher seroconversion rates.

Follow-up standard agglutination and 2-mercaptoethanol tests in 175 clinically cured cases of human brucellosis.

BACKGROUND: The standard agglutination (SAT) and 2-mercaptoethanol (2-ME) tests are usually used in the follow-up of treated cases of human brucellosis. The purpose of this study was to monitor the levels of these tests, two years after clinical cure in cases of brucellosis. METHODS: From April 2003 to September 2008, 175 clinically cured cases of brucellosis (103 males, 72 females) were evaluated. Diagnosis of brucellosis was established with a SAT of > or =1:320 and a 2-ME of > or =1:80, with clinical symptoms and signs compatible with brucellosis. SAT and 2-ME were retested at the end of therapy and at 3-monthly intervals for two years. Serologic cure was considered in the event of a SAT titer decrease to < or =1:160 or a 2-ME decrease to<1:80. RESULTS: The mean age of study patients was 31 +/- 13.5 years. At 6, 12, 18, and 24 months after treatment, SAT titers > or =1:320 were seen in 41 (23.4%), 22 (12.6%), 7 (4%), and 6 (3.4%) cases, respectively, whereas 2-ME titers > or =1:80 were seen in 51 (29.1%), 24 (13.7%), 12 (6.9%), and 8 (4.6%) cases, respectively. The probability of serologic cure for patients with SAT titers < or =1:640 was higher than for those >1:640 (95% confidence interval (CI) 2.5-3.47, p=0.023). The probability of serologic cure for patients with 2-ME titers < or =1:320 was higher than for those >1:320 (95% CI 2.48-3.5, p=0.04). CONCLUSIONS: SAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.

Childhood brucellosis in Babol, Iran.

This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.