Open AccessManagement of Chronic Hepatitis B in Children
Author(s) -
Shah Uzma,
Kelly Deirdre,
Chang MeiHwei,
Fujisawa Tomoo,
Heller Solange,
GonzálezPeralta Regino P,
Jara Paloma,
MieliVergani Giorgina,
Mohan Neelam,
Murray Karen F
Publication year - 2009
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e318197196e
Subject(s) - medicine , cirrhosis , chronic infection , immunology , hepatitis b virus , hepatocellular carcinoma , hepatitis b , immune system , viral hepatitis , viral load , virology , virus
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.