Host and environmental factors influencing hepatitis B e antigen seroconversion in children
Bibliographic record
Abstract
We would like to thank Dr. Karthik et al. for their interest in our review and their comments regarding the natural history of chronic hepatitis B in children. In their letter, Karthik et al. report the results of a follow-up study of a multi-ethnic cohort of 41 Hepatitis B e Antigen (HBeAg) positive children, 36 perinatally infected and 32 coming from different geographical areas of Asia and living in the United Kingdom [[1]Karthik S.V. Davison S. High spontaneous seroconversion in e-antigen positive South Asian children with chronic hepatitis B infection.J Hepatol. 2008; 49: 1079Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar]. The relatively high proportion of Indian children who seroconverted to anti-HBe (25% over an average period of 32 months, all perinatally infected) versus none of the other children from Far-East or Southeast Asia confirmed the role of ethnicity, but also postulated the importance of environment in accelerating disease remission. Immune-mediated lysis of HBV-infected hepatocytes precedes spontaneous seroconversion from HBeAg to anti-HBe and several factors related to the virus, host and environment could modulate the immune response. In a recent study, Zacharakis et al. [[2]Zacharakis G. Koskinas J. Kotsiou S. Pouliou E. Papoutselis M. Tzara F. et al.Natural history of chronic hepatitis B virus infection in children of different ethnic origins: a cohort study with up to 12 years’ follow-up in northern Greece.J Pediatr Gastroenterol Nutr. 2007; 44: 84-91Crossref PubMed Scopus (33) Google Scholar] found that the anti-HBe seroconversion rate was lower in Muslim than in Christian children living in the same region of Greece. In this series the mode of acquisition of infection (perinatal from HBeAg positive mother among Muslim children; preferably postnatal in Christian children) would play a major role in determining rate and timing of anti-HBe seroconversion. HBV genotype distribution seemed to be uninfluential in these children who were almost invariably infected by HBV genotype D. It can be hypothesized that improvement of living conditions could enhance the immunological response, thus favoring HBeAg immunoclearance. This could be the case of the perinatally infected Asian children living in Canada and described by Marx et al. [[3]Marx G. Martin S.R. Chicoine J.F. Alvarez F. Long-term follow-up of chronic hepatitis B virus infection in children of different ethnic origin.J Infect Dis. 2002; 186: 295-301Crossref PubMed Scopus (67) Google Scholar]. Accordingly, an Italian study [[4]Giacchino R. Zancan L. Vajro P. Verucchi G. Resti M. Barbera C. et al.Hepatitis B virus infection in native versus immigrant or adopted children in Italy, following the compulsory vaccination.Infection. 2001; 29: 188-191Crossref PubMed Scopus (30) Google Scholar] including 120 postnatally infected children adopted from Eastern Europe showed that within a couple of years 40% of these patients had spontaneously seroconverted to anti-HBe. Taken together these experiences suggest the need to coordinate information and to plan adequate monitoring of HBV infected children coming from endemic areas before taking therapeutic decisions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".