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Published on: September 25, 2019
Pharmacotherapy options for managing hepatitis B in children
Haruki Komatsu1, Ayano Inui2, Sachiyo Yoshio3
1Department of Pediatrics, Toho University, Sakura Medical Center, Chiba, Japan.
Antiviral treatments for children with chronic hepatitis B virus (HBV) infection are now more accessible. Guidelines vary, but nucleos(t)ide analogues (NAs) and pegylated interferon (PEG-IFN) are recommended first-line options.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Virology
Background:
- The World Health Organization (WHO) aims to eliminate viral hepatitis by 2030, with a focus on hepatitis B and C.
- Effective treatment strategies for children with chronic hepatitis B virus (HBV) infection are crucial for reducing childhood mortality.
- Understanding treatment criteria and available antivirals is essential for managing pediatric HBV.
Purpose of the Study:
- To review the current antiviral treatment options for children diagnosed with chronic hepatitis B virus (HBV) infection.
- To discuss the available antiviral medications approved for pediatric use in managing chronic HBV.
- To provide insights into treatment guidelines and expert opinions on pediatric HBV management.
Main Methods:
- Systematic review of antiviral treatments for chronic hepatitis B virus (HBV) infection in children.
- Analysis of available antiviral medications, including nucleos(t)ide analogues (NAs) and pegylated interferon (PEG-IFN).
- Comparison of international and WHO guidelines for initiating antiviral therapy in pediatric HBV cases.
Main Results:
- The availability of nucleos(t)ide analogues (NAs) and pegylated interferon (PEG-IFN) has facilitated the initiation of antiviral treatment in children.
- International guidelines generally align on treatment criteria for pediatric chronic HBV, while WHO guidelines adopt a more cautious approach.
- Both PEG-IFN and NAs with a high genetic barrier to drug resistance are considered first-line treatments for children.
Conclusions:
- Nucleos(t)ide analogues (NAs) can serve as a first-line treatment option for children, particularly in resource-limited settings.
- While the 'immune-tolerant phase' concept is debated, current evidence does not support treating HBeAg-positive immune-tolerant children.
- Treatment decisions for pediatric chronic HBV should consider guideline recommendations, drug resistance profiles, and resource availability.
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