Management of chronic hepatitis B virus infection in children and pregnant women

Chronic hepatitis B virus (HBV) infection is a major global health burden. Despite successful immunoprophylaxis program and advancement in antiviral therapies in the past decades, there are still an enormous load of afflicted people, mostly adults born before HBV universal vaccination program and children with hepatitis B immunization failure. Infected children, like adults, may experience hepatitis activity and chronic consequences without awareness and thus require screening, followed by close monitoring and proper treatment. Pregnant women with HBV infection are a special group that may need screening to identify as well as monitor disease activity and viral loads, not only during pregnancy but also postpartum, to implement proper management for either maternal or fetal health and/or for prevention of mother-to-infant transmission of HBV. Although there are approved antiviral therapies for adults with chronic hepatitis B, the best practice and long-term impacts in children, and pregnant women/offspring are still evolving. To eradicate global HBV endemics, preventive vaccination is the frontline program; screening, monitoring, antiviral therapy, and surveillance of complications, such as cirrhosis and hepatocellular carcinoma, are the backup strategies which should include children and pregnant women as a whole. ? Springer Nature Singapore Pte Ltd. 2018. All rights reserved.