临床儿科学：开放获取
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Correlation Between Clinical Indicators and Liver Pathology in Children with Chronic Hepatitis B

Chenyang Huang, Ying Lu, Ziwei Wang, Qiyu Jiang, Yi Dong, Lili Cao, Jianguo Yan, Zhiqiang Xu, Fuchuan Wang, Yinjie Gao, Junliang Fu, Min Zhang, Fu-Sheng Wang

Background: Chronic Hepatitis B (CHB) in children presents a significant global health challenge, with liver inflammation and fibrosis being critical concerns for disease progression and long-term outcomes.

Methods: This retrospective study analyzed 1629 pediatric CHB patients from the Fifth Medical Center of Chinese PLA General Hospital, spanning from January 2000 to December 2021. Liver biopsies were performed to assess the severity of liver inflammation and fibrosis. Key clinical Indicators, including age, Alanine Amino Transferase (ALT), Aspartate Amino Transferase (AST), and Gamma-Glutamyl Transferase (GGT), were evaluated for their predictive value in determining disease severity using restricted cubic spline regression models.

Results: Significant nonlinear associations were found between the clinical indicators and liver pathology. Older age was strongly associated with increased risks of moderate to severe inflammation (OR 2.21, 95% CI: 1.34-3.63, p=0.002) and significant fibrosis (OR 2.22, 95% CI: 1.31-3.77, p=0.003). Elevated ALT levels (≥ 80U/L) were correlated with a higher likelihood of moderate to severe inflammation (OR 1.82, 95% CI: 1.05-3.15, p=0.033), while higher GGT levels (≥ 50U/L) were significantly associated with advanced fibrosis (OR 2.62, 95% CI: 1.72- 3.99, p<0.001).

Conclusion: Regular monitoring of ALT, AST, and GGT levels is essential for early detection and management of liver inflammation and fibrosis in pediatric CHB patients. These findings underscore the importance of tailored therapeutic strategies based on age and clinical indicators profiles to mitigate disease progression in this vulnerable population.