Pediatric Drugs

, Volume 15, Issue 4, pp 311–317 | Cite as

Chronic Hepatitis B in Children and Adolescents: Epidemiology and Management

Review Article

Abstract

Hepatitis B virus (HBV) infection is a worldwide health problem, which can cause acute liver failure, acute hepatitis, chronic hepatitis, liver cirrhosis, and liver cancer. It is most prevalent in Asia, Africa, Southern Europe, and Latin America. Approximately 2 billion people in the world have been infected by HBV, with more than 350 million as chronic carriers. Implementation of the HBV vaccine led to a significant reduction in viral transmission in many areas of the world; however, it remains highly endemic in many developing countries. The main source of infection in childhood is via perinatal transmission or horizontal transmission during preschool years. The majority of children with chronic hepatitis B (CHB) infection are asymptomatic; however, they may develop progressive disease and are at increased risk of advanced liver disease or liver cancer before their third decade. All children with chronic HBV infection should be regularly monitored for disease progression. The goal of therapy for children with CHB is to arrest disease progression and reduce the risk of developing cirrhosis and cancer. The available medications have a low success rate because of immunotolerance in the child and the development of viral resistance to standard therapy. Therefore, case selection and determination of the best time to commence treatment are essential to increase treatment efficacy and reduce the risk of viral resistance.

Notes

Acknowledgments

No sources of funding were used to assist in the preparation of this review. Professor Kelly has received research grants for hepatitis B studies from BMS, Roche, MSD, Janssen, Vertex, and Novartis, and consulting fees from Sanofi Pasteur MSD for advisory meetings. Dr Abdel-Hady has no conflicts of interest to declare.

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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Liver Unit, Birmingham Children’s HospitalBirminghamUK

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