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Objective — to study the peculiarities of chronic viral hepatitis B (CHB) in children, depending on the duration of the disease, strain of the virus and viral load. We have examined 61 children aged 3–18 years with CHB. All patients underwent clinical, laboratory and instrumental examination. The clinical course of CHB was evaluated by the presence of clinical and laboratory syndromes throughout the entire period of the disease. Using polymerase chain reaction and enzyme-linked immunosorbent assay, we have identified strain of hepatitis B virus (HBV) and viral load. Liver fibrosis was assessed using the APRI index. CHB in one third of children was characterized by inactive course (immune tolerant phase), half of the patients had low and minimal activity of the inflammatory process in the liver with minimal clinical symptoms. In 55.9 % of children, horizontal transmission of the virus took place. It was found that in patients with high viral load and a wild-type HBV, CHB had significantly more active course. With increasing CHB duration, the viral load decreases. Moderate direct correlation between strain of the virus and viral load and strong correlation with the activity of the process in the liver has been established. In children with CHB, the activity of hepatitis is a predictor of hepatic fibrosis progression.

This review article deals with the possibility of using the quantitative determination of HBsAg (qHBsAg) to monitor the natural history of the disease. The necessity of unification of qHBsAg use to monitor the natural history of the disease and antiviral therapy, with insuring recommendations in the continental guidelines for HBV-infection, is indicated.