Hepatitis B and C in children | Nature Reviews Gastroenterology & Hepatology

ABSTRACT Chronic infection with hepatitis B affects nearly 350 million individuals worldwide and is the leading cause of hepatocellular carcinoma and liver cirrhosis. Universal infant

immunization has decreased rates of HBV infection, although transmission continues to occur via vertical (mother-to-child) and horizontal (sexual, parenteral and household) routes.

Treatments are now available for children with chronic HBV infection, but appropriate selection of those most likely to respond to treatment is important. Interferon _α_ and lamivudine are

currently approved in the US for the treatment of children older than 2 years of age who have chronic HBV infection. Hepatitis C infection affects almost 170 million individuals worldwide.

Of individuals exposed to HCV, 60–80% develop chronic hepatitis, and 10–15% of those chronically infected develop cirrhosis within several decades. No vaccine exists for HCV; therefore,

prevention of parenteral transmission is important. A high index of suspicion is essential for the diagnosis of HCV infection given its silent clinical presentation. Appropriate evaluation

of infected individuals is warranted when considering their suitability for therapy. Interferon _α_ and ribavirin, used in combination, are currently approved in the US for the treatment of

children older than 3 years of age with chronic HCV infection. KEY POINTS * The implementation of universal infant hepatitis B immunization has reduced vertical transmission rates by 85–90%,

and has similarly reduced the rates of hepatocellular carcinoma due to hepatitis B * Without prophylaxis, neonates exposed to HBV have a greater than 90% risk of developing chronic

infection, in comparison to adults, who, when exposed, only have a 2–10% risk of developing chronic infection * Determination of active viral infection and associated hepatocellular

inflammation is important when considering antiviral therapy for patients with chronic hepatitis B * HCV infection usually occurs without symptoms, and most infected individuals develop

chronic infection * HCV genotype is important in the prediction of treatment response to antiviral therapy * Liver biopsy is imperative to determine the degree of hepatocellular injury from

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Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS HEPATITIS A VIRUS INFECTION Article 28 September 2023 GLOBAL BURDEN OF HEPATITIS B VIRUS: CURRENT STATUS, MISSED OPPORTUNITIES

AND A CALL FOR ACTION Article 06 April 2023 PREVALENCE, INCIDENCE, AND OUTCOMES OF HEPATITIS E VIRUS COINFECTION IN PATIENTS WITH CHRONIC HEPATITIS C Article Open access 21 August 2023

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references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Division of Gastroenterology and Nutrition, EK Hsu is a first year Fellow in Pediatric Gastroenterology at The Children's

Hospital of Philadelphia, Philadelphia, PA, and KF Murray is Director of the Hepatobiliary Program, Children's Hospital and Regional Medical Center, Seattle, WA, USA., Evelyn K Hsu 

& Karen F Murray Authors * Evelyn K Hsu View author publications You can also search for this author inPubMed Google Scholar * Karen F Murray View author publications You can also search

for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Karen F Murray. ETHICS DECLARATIONS COMPETING INTERESTS Karen F Murray has received grant/research support

from Gilead, Roche and Schering-Plough. Evelyn K Hsu declared no competing interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hsu, E., Murray, K.

Hepatitis B and C in children. _Nat Rev Gastroenterol Hepatol_ 5, 311–320 (2008). https://doi.org/10.1038/ncpgasthep1124 Download citation * Received: 28 March 2007 * Accepted: 21 February

2008 * Published: 15 April 2008 * Issue Date: June 2008 * DOI: https://doi.org/10.1038/ncpgasthep1124 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

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