Treatment of children with chronic viral hepatitis: what is available and what is in store
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Treatment of children with chronic viral hepatitis: what is available and what is in store Pietro Vajro, Claudio Veropalumbo, Sergio Maddaluno, Mariacarolina Salerno, Giancarlo Parenti, Claudio Pignata Baronissi, Italy
Review article
Background: At present, therapy of children with chronic hepatitis B and C is still based on few drugs, all burdened by a series of side-effects, unsatisfactory serum conversion rates, and/or drug-resistance. Moreover, selection of subjects to treat with conventional therapies is not univocal, especially during the pediatric age when the disease course is often mild with significant spontaneous seroconversion rate. Our review deals with pros and cons points when a physician decides to design a drug therapy for a child with chronic viral hepatitis, and different possible therapeutic opportunities.
Introduction
V
Results: The management of children with viral hepatitis is still controversial over whom and when to treat and the use of drug(s). Novel therapeutic strategies have been evaluated only in clinical and preclinical trials involving, for instance, "therapeutic" vaccines. The data on safety and effectiveness of new drugs are also reviewed.
iral hepatitis due to hepatitis B virus (HBV) and C virus (HCV) continue to be a major global health problem, despite the introduction of HBV vaccine. The risk of HBV infection is also increasing in the Western population because of international adoption and immigration flow coming from high prevalence countries.[1] In this paper, we reviewed the management of chronic HBV and HCV focusing also on available and possible novel pharmacological approaches which still have poor evidence and are controversial in pediatric patients. A literature search was performed through PubMed using key words such as viral hepatitis treatment/ therapy, interferon (IFN), pegylated-IFN (Peg-IFN), ribavirin (RBV), lamivudine, new antiviral drugs, vaccine, viral hepatitis, and children alone or in combination. Original articles, reviews, systematic reviews, and the latest guidelines were selected.
Conclusion: The results of reported studies confirmed that at least some of the new drugs, with greater efficacy and/or minor side-effects, will be used clinically.
Hepatitis B virus
Methods: A literature search was performed through PubMed. The newest articles, reviews, systematic reviews, and guidelines were included in this review.
World J Pediatr 2013;9(3):212-220 Key words: children; hepatitis B; hepatitis C; therapy
Author Affiliations: Department of Medicine and Surgery, University of Salerno, Baronissi (Salerno), Italy (Vajro P); Department of Translational Medical Sciences, Pediatrics, University of Naples "Federico II", Naples, Italy (Veropalumbo C, Maddaluno S, Salerno M, Parenti G, Pignata C) Corresponding Author: Pietro Vajro, Chair of Pediatrics, Department of Medicine and Surgery, University of Salerno, Via Allende 84081, Baronissi (Salerno), Italy (Tel: +39-089-672409; Email: [email protected]) doi: 10.1007/s12519-013-0426-0 ©Children's Hospital, Zhej
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