Citation

Rehmanm A, Mazhar A. Pak. Pediatr. J. 2010; 34(2): 94-106.

Copyright

(Copyright © 2010, Pakistan Paediatric Association)

DOI

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PMID

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Abstract

Hepatitis B and C infections are very common in children in Pakistan. There are very few hepatologists in Pakistan to manage such cases. This article gives guidelines for the management of such cases by the primary pediatrician. The antiviral treatment of acute hepatitis B and C is not commonly recommended. The treatment of chronic hepatitis B infection (defined as detectable HBsAg for at least 6 months) is mainly based on the degree of liver damage caused by hepatitis B virus as well as viral load while treatment of chronic hepatitis C infection (defined as the persistence of HCV RNA for at least six months) is based on viral load of hepatitis C virus. Most of the authorities recommend treatment for chronic hepatitis B and C in children over 2 years of age. Interferon-α is the therapy of choice for children with chronic hepatits B while the second line of drug is lamivudine which is used in interferon-α nonresponders/contraindications to interferon-α. Children with chronic hepatitis C is treated with pegylated interferon alfa-2b in combination with ribavirin for duration of 48 weeks irrespective of genotype.

Language: en

Keywords

human; child; depression; anger; liver biopsy; anxiety; behavior change; suicide attempt; kidney disease; monitoring; mood disorder; lamivudine; Lamivudine; visual impairment; pediatrician; review; epilepsy; fatigue; anorexia; mental disease; personality disorder; serology; weight reduction; pathophysiology; autoimmune disease; vaccination; neutropenia; thrombocytopenia; disease course; patient referral; practice guideline; alpha interferon; drug withdrawal; Interferon; hepatitis C; Hepatitis C; irritability; neurologic disease; side effect; alopecia; heart disease; anemia; arthralgia; flu like syndrome; Hepatitis C virus; hyperthyroidism; myalgia; ribavirin; alanine aminotransferase; liver injury; organ transplantation; leukocyte count; drug contraindication; Management; hypothyroidism; Hepatitis B; histopathology; hepatitis B; laboratory test; drug fever; peginterferon alpha2a; peginterferon alpha2b; virus RNA; Coinfection; Hepatitis B virus; treatment response; entecavir; nucleoside analog; tenofovir; virus replication; genotype; virus load; decompensated liver cirrhosis; drug induced headache; antibody response; thrombocyte count; treatment duration; cytopenia; alanine aminotransferase blood level; hepatomegaly; absence of side effects; hepatitis B(e) antigen; febrile convulsion; mixed infection; adefovir; hepatitis B antibody; hepatitis B surface antigen; thalassemia; immunological tolerance; alpha fetoprotein; delta agent hepatitis; hepatitis A vaccine; Liver biopsy; Thalassemia