Viral Hepatitis B—Management in Children

Chronic hepatitis B (CHB) infection is a worldwide health problem with significant morbidity. Children with CHB require a lifetime of monitoring for infection activation, hepatic disease and its complications, and hepatocellular carcinoma (HCC). Children with CHB which is in the immune active stage are candidates for antiviral treatment. As new medications have been approved for children, the treatment recommendations have changed. This review summarizes the recent data. With the demonstration of safety and efficacy of entecavir and tenofovir in children, previously used medications like lamivudine and adefovir are no longer recommended as the first-line treatments. Health care providers should provide counseling regarding monitoring, natural history, and transmission to children with CHB and their families. Children in the immune active stage are candidates for antiviral treatment. With more approved therapies over the last few years for a wider age range of children, there are safe, effective, and well-tolerated therapeutic options.