Management of chronic hepatitis B in children
Journal
Journal of Pediatric Gastroenterology and Nutrition
Journal Volume
48
Journal Issue
4
Pages
399-404
Date Issued
2009
Author(s)
Shah U.
Kelly D.
Fujisawa T.
Heller S.
Gonz?lez-Peralta R.P.
Jara P.
Mieli-Vergani G.
Mohan N.
Murray K.F.
Abstract
Hepatitis B virus (HBV) infection is a worldwide problem and can cause acute liver failure, acute hepatitis, chronic hepatitis, liver cirrhosis, and liver cancer. In areas of high prevalence such as in Asia, Africa, southern Europe, and Latin America, the hepatitis B surface antigen positive rate ranges from 2% to 20%.In endemic areas, HBV infection occurs mainly during infancy and early childhood. Mother-to-infant transmission accounts for approximately half of the chronic HBV infections. In contrast to infection in adults, HBV infection during early childhood results in a much higher rate of persistent infection and long-term serious complications such as liver cirrhosis and HCC.Three phases of chronic hepatitis B have been identified: the immune-tolerant phase, the immune-active phase, and the inactive hepatitis B phase. These phases of infection are characterized by variations in viral replication, hepatic inflammation, spontaneous clearance, and response to antiviral therapy.The optimal goal of antiviral therapy for chronic HBV infection is to eradicate HBV and to prevent its related liver complications. However, due to the limited effect of available therapies in viral eradication, the goal of treatment is to reduce viral replication, to minimize liver injury, and to reduce infectivity. In this review the current recommendations for monitoring and treating chronic HBV infection in children are reviewed. ? 2009 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Subjects
Chronic hepatitis B virus; Pediatrics; Viral hepatitis
SDGs
Other Subjects
adefovir; alanine aminotransferase; alpha interferon; alpha2b interferon; entecavir; hepatitis B surface antigen; interferon; lamivudine; peginterferon; placebo; telbivudine; tenofovir disoproxil; alopecia; antiviral therapy; autoimmune disease; autoimmune thyroid disease; bone marrow suppression; chronic hepatitis; clinical protocol; clinical trial; competitive inhibition; depression; drug fever; drug half life; eradication therapy; flu like syndrome; hepatitis B; Hepatitis B virus; human; Human immunodeficiency virus infection; infancy; liver biopsy; liver cell carcinoma; membranoproliferative glomerulonephritis; mental disease; mixed infection; patient monitoring; persistent infection; prevalence; priority journal; review; treatment indication; vertical transmission; virus infectivity; virus replication; Antiviral Agents; Child, Preschool; Hepatitis B virus; Hepatitis B, Chronic; Humans; Infant; Hepatitis B virus
Type
review