Key Concepts
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Identification of children with hepatitis B or hepatitis C requires a heightened awareness of whom to screen, and which tests to obtain.
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Recent recommendations for hepatitis B case identification include screening of any person born in an area of the world where the prevalence exceeds 2%, or children born in the USA to parents who have emigrated from endemic regions.
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Chronic hepatitis B is a life-long disease that requires monitoring that is best managed as a partnership between the primary practitioner and the specialist.
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Vaccination is the best method of preventing hepatitis B transmission and titer measurement post-vaccination is recommended for close contacts.
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Like hepatitis B, hepatitis C in childhood frequently is undetected without knowing whom to screen.
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The best method of testing for hepatitis C is determination of antibody (anti-HCV).
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Children in whom HCV RNA is detected by PCR should be referred for consideration of treatment. Quantitative hepatitis C RNA and genotype testing are helpful in making treatment decisions and determining the likelihood of treatment response.
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Social aspects of both hepatitis B and C are essential areas of discussion for the practitioner, who should address alcohol use, illicit drugs, and sexual transmission.
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Family members of children with hepatitis B or hepatitis C should undergo appropriate testing and teaching about strategies to reduce transmission within the home.
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Children with hepatitis B or hepatitis C should not be excluded from school or extracurricular activities. Universal precautions that should already be in place in these settings are sufficient.
Keywords
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Erlichman, J., Mellman, W., Haber, B.A. (2010). Primary Care of Children with Viral Hepatitis: Diagnosis, Monitoring, and General Management. In: Jonas, M. (eds) Viral Hepatitis in Children. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-373-2_9
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