Clinical Analysis Of Nucleoside Analogues In The Prevention And Treatment Of Reactivation Of Hepatitis B Virus In Children

Objective:To investigate the therapeutic effect of nucleoside analogues(NAs)on the reactivation of hepatitis B virus(HBV)in children withchronicHBVinfectiontreatedwithchemotherapyor immunosuppressive agents,and the prophylactic effect of antiviral drugs on HBV reactivation before treatment.Methods:Patients with chronic HBV infection who received chemotherapy or immunosuppressive agents from January 2009 to December 2018 in the children's hospital affiliated to chongqing medical university were selected as the study cases.The non-prevention group was treated with standardized chemotherapy or immunosuppressive agents,and the NAs preventive antiviral therapy was not given.The hepatitis B virus replication and liver function were observed after treatment;In the prevention group,NAs was used 1-2 weeks before chemotherapy or immunosuppressive therapy,and at least 3 months of continuous NAs were used to observe the reactivation of HBV and liver function.Results:A total of 41 patients were collected,and a total of 18patients had HBV reactivation.Among the 16 patients in the prevention group,1 patient(6.3%)had HBV reactivation,and among the 25 children in the control group,17 patients(68.0%)had HBV reactivation.There was a significant difference in the HBV reactivation rate between the two groups(X~2=12.7,P<0.001).Among them,1 patient in the prevention group was reactivated due to non-standardized use of NAs,and 11 patients in the non-prevention group were treated with NAs antiviral therapy after reactivation,resulting in 9 patients with decreased HBV DNA and 2patients with increased HBV DNA again after secondary infection.Conclusion:All patients with chronic HBV infection requiring chemotherapy or immunosuppressive agents should be routinely screened for HBV serological markers,HBV DNA,and liver function before treatment.In order to reduce the occurrence of HBV reactivation and improve the clinical prognosis,NAs antiviral therapy should be standardized in time for these patients.The timely and standardized use of NAs against HBV in patients with reactivation of hepatitis B is also of great significance in reducing the replication of hepatitis B virus and alleviating liver function damage.