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Treatment of viral hepatitis B in children

Raffaella Giacchino1, Barbara Cappelli

  • 1Infectious Diseases Unit, Istituto Giannina Gaslini - Ospedale Pediatrico IRCCS, Largo G. Gaslini, 5, Genoa 16147, Italy. raffaellagiacchino@ospedale-gaslini.ge.it

Expert Opinion on Pharmacotherapy
|March 6, 2010
PubMed

Insights

Current treatments for chronic hepatitis B (CHB) in children, like interferon-alpha and lamivudine, have limitations. Treatment decisions for pediatric CHB should consider spontaneous viral clearance and liver damage extent.

Area of Science:

  • Pediatric Hepatology
  • Viral Hepatitis Research
  • Clinical Therapeutics

Background:

  • Chronic hepatitis B (CHB) in children requires management to reduce viral replication and liver injury.
  • Active viral liver infection in pediatric patients necessitates therapeutic intervention.

Purpose of the Study:

  • To review current and emerging treatment options for chronic hepatitis B in children.
  • To summarize treatment strategies for pediatric CHB based on existing literature and clinical experience.

Main Methods:

  • Comprehensive literature review of PubMed/Medline database from 1982 to 2009.
  • Analysis of treatment options for both adult and pediatric CHB patients.
  • Incorporation of clinical experience into treatment recommendations.

Main Results:

  • Limited standardized treatment options exist, including interferon-alpha and lamivudine.
  • Interferon-alpha shows efficacy but has frequent side effects in children; HBeAg clearance rates are comparable to spontaneous seroconversion.
  • Lamivudine is effective for active viral replication but carries a risk of drug-resistant mutations.

Conclusions:

  • Treatment decisions for pediatric CHB must weigh the potential for spontaneous viral clearance.
  • The extent of liver damage is a critical factor in determining the necessity of CHB treatment in children.
Abstract

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