Breakthroughs and challenges in the management of pediatric viral hepatitis

Area of Science:

• Hepatology and Virology
• Pediatric Infectious Diseases
• Gastroenterology

Background:

• Chronic hepatitis B (HBV) and hepatitis C (HCV) infections are significant global causes of liver disease and mortality.
• While often asymptomatic in childhood, persistent HBV and HCV infections pose long-term health risks.
• Advances in HCV treatment highlight the need for improved HBV therapies, which are not yet curative.

Purpose of the Study:

• To review current direct-acting antiviral (DAA) treatments for pediatric HCV and their real-world application.
• To critically examine the classification of HBV in pediatric populations.
• To explore investigational anti-HBV compounds targeting pediatric pathophysiology and provide management recommendations.

Main Methods:

• Literature review of direct-acting antivirals for pediatric HCV (sofosbuvir/ledipasvir, sofosbuvir/velpatasvir, glecaprevir/pibrentasvir).
• Critical analysis of existing pediatric HBV classification systems.
• Review of preclinical and clinical data for investigational anti-HBV agents (e.g., capsid assembly modulators, immune modifiers).

Main Results:

• Several DAAs are available and used in real-world settings for pediatric HCV treatment.
• A critical review of pediatric HBV classification is presented.
• Various novel anti-HBV investigational compounds targeting specific viral mechanisms are under development for pediatric use.

Conclusions:

• Direct-acting antivirals offer effective treatment options for pediatric HCV.
• Further research and development are crucial for curative HBV therapies in children.
• Guidelines for screening and managing pediatric patients with HBV/HCV, especially those who are immunosuppressed or have comorbidities, are essential.