[Treatment of chronic hepatitis B in children].
Hepatitis B virus (HBV) infection is an important health problem. It's believed that there are now at least 400 million carriers of HBV in the world. Infants born to HBeAg-positive carrier mothers have a 60% to 90% chance of contracting chronic hepatitis B infection and of possible subsequent progression to cirrhosis and hepatocellular carcinoma. Treatment of chronic hepatitis B is aimed at sustained suppression of HBV replication and remission of liver disease. Treatment with interferon alpha has a 36% to 45% remission rate after a four-month course of treatment in selected patients. The criteria of good response for the treatment include elevated aminotranspherase levels, the presence of HBV DNA but a level of less than 200 pg/mL, and a liver biopsy suggesting moderate or severe inflammatory activity. Interferon can be used alone or concurrently with lamivudine in chronic hepatitis patients. Although there were hopeful data about the efficacy of lamivudine therapy, the combination of more than one antiviral agent needs to be assessed to improve the actual response rate obtained with interferon-alpha. Preliminary reports suggest that 73% to 86% of patients remained HBeAg-negative after HBeAg seroconversion in clinical trials, but some responders who had early relapse were not included in these follow-up studies, so these results may be overly optimistic.
Bahar
Arif
A
Abt. für Kinderheilkunde, Akademie Haydarpasa Gulhane, Militärisches Medizinisches Trainingskrankenhaus, Istanbul, Türkei. Arbahar@Hotmail.com
Karademir
Ferhan
F
D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000451:nursing* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D011247:Pregnancy; D011379:Prognosis; D018570:Risk Assessment
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D019259:Lamivudine