Hepatitis B in children: Complexities in management

@article{Kerkar2005HepatitisBI,
  title={Hepatitis B in children: Complexities in management},
  author={Nanda Kerkar},
  journal={Pediatric Transplantation},
  year={2005},
  volume={9}
}
  • N. Kerkar
  • Published 1 October 2005
  • Medicine, Biology
  • Pediatric Transplantation
Abstract:  Chronic hepatitis B virus (HBV) infection by definition is persistence of hepatitis B surface antigen (HBsAg) in the serum for ≥6 months. The risk of developing chronic HBV infection ranges from 90% in neonates to <5% in immunocompetent adults. HBV acquired by perinatal infection has a prolonged immune‐tolerant phase, characterized by the presence of hepatitis Be antigen (HBeAg), high HBV‐DNA and normal alanine aminotransferase (ALT) levels. Efficient and multi‐specific helper and… 
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Practice guidelines on the management of hepatitis include achievement of HBeAgseroconversion, and suppression of HBV DNA below the level of detection, and prevent progression to cirrhosis and HCC, and prolong survival.
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TLDR
The combination of entecavir and peginterferon for up to 48 weeks rarely led to loss of HBeAg with sustained suppression ofHBV DNA levels in children in the immune‐tolerant phase of HBV infection, and treatment was associated with frequent AEs.
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TLDR
It is the consensus of the panel that it is not appropriate to treat children in the immune‐tolerant phase or in the inactive carrier state and the current goals of therapy are to suppress viral replication, reduce liver inflammation, and reverse liver fibrosis.
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TLDR
Hepatitis B virus infection can lead to chronic carriage of the virus and progressive liver diseases, such as hepatitis, liver cirrhosis and hepatocellular carcinoma, and HBV and hepatitis C virus or HIV coinfections can increase the HCC risk.
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TLDR
Standard-dose IFN-alpha plus lamivudine treatment was found superior to the other treatment modalities for chronic hepatitis B and Predictors of ETR were similar to those found in previous studies.
Cost-Effectiveness of Testing Hepatitis B–Positive Pregnant Women for Hepatitis B e Antigen or Viral Load
TLDR
Testing HBsAg-positive pregnant women for HBeAg or HBV load followed by maternal antiviral prophylaxis if HBe Ag-positive or high viral load to reduce perinatal hepatitis B transmission in the United States is cost-effective.
Treatment options for chronic hepatitis B and C infection in children
TLDR
It is recommended that therapy should be offered to children with CHB who have an elevation in alanine aminotransferase for more than 6 months and therapy with interferon-αshould be offered in the majority of cases with the aim of immune clearance as measured by early antigen seroconversion.
A Study on the Relationship of Hepatitis B Virus with Hepatocellular Carcinoma
TLDR
A positive relationship on the pattern of HBsAg amongst the liver diseases under study is shown, and of the two staining techniques employed, orcein shikata gave a better result with ease in recognition and quick screening.
Hepatocellular carcinoma and other liver disease among Greenlanders chronically infected with hepatitis B virus: a population-based study.
TLDR
The relatively low incidence of hepatocellular carcinoma and other HBV-related morbidity among chronicHBV-infected persons in Greenland suggest a more benign course of HBV among the Greenlandic Inuit than in populations in other parts of the world.
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