Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Chronic infections and liver diseases may influence the growth and development of children by leading to malnutrition. Aim of work: To assess growth and growth velocity in chronically HBV infected children following at the pediatric hepatology clinic, Cairo university children's hospital and to correlate the growth parameters to disease activity and effect of therapy. Methods: This observational study included 57 children. Their data were retrieved from files including: name, age, clinical history, anthropometric measurements, investigations and treatment received. Results: The studied cases included 35 males. Their age ranged between 3 months and 16 years at their first presentation. History of maternal HBV was present in 96.5% of the patients. Thirty-three cases were immune tolerant at time of presentation. Baseline anthropometric measures showed that 2 cases had weight and height SD below <-2, 5 cases had height SDs <-2 and 1 case had weight and BMI SD < - 2.No significant difference was observed in growth velocity of studied cases regarding treatment status (p=0.42). Seroconversion (HBeAb positivity) was achieved in 21 cases (36.8%). In cases with positive HBeAb, seven cases showed improvement in weight and 4 showed improvement in height compared to cases with HBeAb negative who showed no change (p=0.02). Levels of transaminases were significantly higher among cases with negative HBeAb (p=0.019). There was no effect on height velocity in patients receiving PEG-IFN during treatment period compared to post treatment follow up velocity (p=0.9). Conclusion: Vertical transmission is the main risk factor for HBV acquisition in Egyptian children. Chronic HBV in children did not show a negative impact on growth parameters or growth velocity. Growth velocity was not affected either by the HBV immune status or treatment type.Patients with HBV seroconversion showed a better improvement in growth parameters

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