Chronic viral hepatitis in childhood

In endemic areas infection with hepatitis B virus is a common cause of chronic liver disease in childhood. High levels of viral replication and mild ALT abnormalities are the rule in children infected perinatally and many of them are likely to maintain viral replication through their youth. Conversely about 90% of children infected later in life clear HBeAg and achieve sustained remission of liver disease before reaching adulthood. The eventual outcome of infection and disease in these patients remains unpredictable as reactivation of liver damage and viral replication may occur after several years of sustained remission. Cirrhosis is a rare and early complication of chronic HBV infection in children, and a risk factor for hepatocellular carcinoma. IFN therapy can accelerate HBV DNA clearance, improving the spontaneous anti-HBe seroconversion rate in Caucasian children by two to three times. Hepatitis delta is the most severe form of chronic viral hepatitis in childhood. Cirrhosis can be diagnosed in up to 26% of patients at presentation, and few cases respond to IFN therapy.

Hepatitis C is relatively rare in children. Before the discovery of HCV, blood transfusions were the most common source of infection. Hepatitis C is usually a mild, asymptomatic disease in otherwise healthy children, but has a poor propensity to spontaneous remission over the years. For this reason, and based on the experience in adults, IFN treatment is now being evaluated.

Author: Bortolotti F, Clinica Medica II, University of Padova, Italy. Source: Baillieres Clin Gastroenterol 10: 185-206 (1996)

Hepatitis C Genotype Guides Health Plans
Because the suggested treatment length and success rates vary between genotypes, this is typically one of the first distinctions made after a Hepatitis C diagnosis. In order to assure the correct course of therapy is approved, health insurance companies are...

Math May Foretell Hepatitis C Drug Success
By doing a math formula calculation on the specific genetics of an individual's Hepatitis C infection, doctors may be able to predict whether or not treatment will be successful....

Treatment Approved for Kids With Hepatitis C
Instead of prescribing the drugs for "off-label use," pediatricians can now feel more confident when treating children with Hepatitis C. Schering-Plough's Rebetol and PEG-Intron have been officially approved by the FDA for treating Hepatitis C in kids aged 3 to...