Treatment of chronic hepatitis B virus infection in children
Tóm tắt
Hepatitis B virus (HBV) remains an important global pathogen. In countries of high endemicity, virus is typically acquired either vertically or during the preschool years, contributing to a large burden of pediatric infection. Seroconversion and progression to the inactive carrier phase of infection is associated with improved outcome and decreased rates of cirrhosis and hepatocellular carcinoma. Success in treating chronic HBV disease in children, as defined by hepatitis B e antigen (HBeAg) seroconversion, approaches only 25% to 30% with interferon-α, the most efficacious agent. Lamivudine and other nucleoside analogues achieve HBeAg seroconversion at slightly lower rates and are better tolerated. However, this class of medications is limited by the frequency of development of mutations in the YMDD locus of the reverse transcriptase gene. Interest is growing in treatment of children in the immune-tolerant stage of infection, thereby holding promise for the largest number of children with HBV infection.
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