Pulmonary function test (PFT) monitoring is recommended in pediatric patients with chronic hepatitis B (CHB), according to an observational case-control study recently published in the Pediatric Infectious Disease Journal.
Even with the implementation of universal immunization and blood screening for hepatitis B virus (HBV), a significant number of children and adolescents are infected each year and develop CHB. CHB infection is a state of chronic viremia that produces both hepatic and extrahepatic manifestations. The spectrum of CHB is wide, ranging from an asymptomatic carrier state to chronic hepatitis with progression to cirrhosis, hepatocellular carcinoma, and end-stage liver disease. Although viral-associated pulmonary disorders have been more commonly associated with hepatitis C virus, their association with CHB is not clear, and studies are scarce and limited to the adult population.
Therefore, researchers evaluated PFT abnormalities in 100 children and adolescents with newly diagnosed CHB over the course of 3 years. They observed a significant progressive decline in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow, total lung capacity, and diffusing capacity of the lung for carbon monoxide in patients with CHB compared with pulmonary function at the beginning of the study and compared with the control group (P <.05).
However, FEV1/FVC and residual volume demonstrated nonsignificant change (P >.05).
Limitations of this study included a relatively small sample size and the selection of only 2 subgroups of CHB (inactive carrier and patients in the immunotolerant phase).
The study authors concluded that, “Subclinical PFT abnormalities are present in children with CHB more than we expected. Hence, we would recommend PFT monitoring in pediatric patients with CHB.”
El Amrousy D, Hassan S, El Ashry H. Chronic hepatitis B infection in children and its relation to pulmonary function tests: A case-control study. Pediatr Infect Dis J. 2020;39:192-196.