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We aimed to analyse sex differences in antiviral treatment response in children with HBV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study on 236 treatment-naive children with chronic HBV infection at the Liver Disease Centre of Hunan Children\u2019s Hospital. The Cox proportional hazard regression was used to estimated treatment outcome differences between males and females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 236 subjects, the median age at treatment initiation was 4 (2,7) years, and 155 (65.68%) were male. After the median follow-up (IQR) of 27 (18, 43) months, the crude cumulative incidence of HBsAg loss, HBeAg clearance and HBV DNA undetectability in patients were 48.73%, 61.02% and 89.36%, respectively. Kaplan-Meier curve showed that female patients were more likely to achieving HBsAg loss compared to male patients (58.02% vs. 43.87%, P\n                      <jats:sub>log\u2212rank<\/jats:sub>\n                      =0.001). After adjustment for other covariates, female sex was significantly associated with the higher possibility of HBsAg loss (female vs. male: Adjusted HR: 2.03, 95% CI: 1.35\u20133.06) in children with chronic HBV infection. Furthermore, the landmark analysis revealed that the relationship between sex and HBsAg loss became more pronounced beyond the first year (female vs. male: adjusted HR (95%CI): 2.18(1.29\u20133.69)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children with chronic HBV infection receiving antiviral treatment are frequently observed to achieve functional cure. Sex plays an important role in treatment response among paediatric patients, with female patients exhibiting a higher likelihood of achieving HBsAg loss, particularly after one- year of follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13293-026-00826-8","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T12:24:55Z","timestamp":1774441495000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex differences in the clinical outcomes of chronic hepatitis B infection among paediatric patients"],"prefix":"10.1186","volume":"17","author":[{"given":"Wenxian","family":"Ouyang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenzhen","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingping","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songxu","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"issue":"5","key":"826_CR1","doi-asserted-by":"publisher","first-page":"765","DOI":"10.3201\/eid2305.161477","volume":"23","author":"F Cui","year":"2017","unstructured":"Cui F, Shen L, Li L, et al. 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