Clinical Evaluation of Co-existence of Hepatitis B Surface Antigen (HBsAg) and Antibodies to HBsAg in Children Experiencing Chronic Hepatitis B

Hepatitis B and hepatitis C viruses are responsible for blood-borne illnesses that are associated with increased mortality rates. Within the scope of this study, our objective was to investigate the characteristics of children who had HBsAb positive CHB. Furthermore, for the purpose of determining whether or not children who had chronic hepatitis B also possessed antibodies to HBsAg and the hepatitis B surface antigen (HBsAg), we conducted testing. The study involved children and adolescents aged 1-17 with chronic hepatitis B in Pakistan, receiving antiviral therapy. The diagnosis was based on abnormal ALT levels, HBsAg positive for over six months, or liver histology showing inflammation, necrosis, or severe fibrosis. Statistical tests and R software were used for comparison. The study was conducted using R software with a significance threshold of p<0.05. The study found no significant differences in the presence of HBsAb and HBV DNA between groups with different HBV genotypes, inflammatory grades, fibrosis stages, and HBeAg positivity rates. However, the HBsAb-positive group had significantly lower median levels of HBsAg and HBV DNA. The risk of HBsAg loss and undetectable DNA increased proportionally with the rise in HBsAb levels at the beginning of treatment. The study also found an independent association between HBsAb positivity and undetectable DNA levels in patients with genotype C and inflammation grades 2–4. Children with both HBsAg and HBsAb have higher clearance rates of HBsAg and HBeAg. The presence of both antibodies in chronic hepatitis B (CHB) suggests an intermediate step in HBsAg clearance. HBsAb-positive CHB children have a higher probability of positive clinical outcomes and act as independent predictors for HBeAg clearance and HBsAg loss. Proactive treatment is crucial for these children.