Article Commentary: What Evidence Exists to Support Antiviral Treatment in Children with Chronic Hepatitis B?

Abstract

Many questions are unanswered on the optimal management of chronically HBV-infected children. Chronic hepatitis B is generally a mild disease in children; however, response to therapy is partial and limited to specific subgroups, and available drugs have no proven advantage on long-term course of disease versus no treatment, and are hampered by numerous limitations. Studies on the natural history of chronic hepatitis B and the long-term results of the therapeutic schedules adopted so far should be critically appraised. A balance between the potential benefits of the treatment and its side effects, and the spontaneous course of the disease left untreated should be made.

Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis

“…Some drugs, such as interferon-α (IFN-α)[ 24 ], lamivudine[ 25 ], entecavir[ 26 ], adefovir[ 27 ] and tenofovir[ 28 ] have been approved for these patients. However, their use is limited by important side effects, risk of resistance development, high costs and, mainly, age of the treated subjects[ 29 ]. Most of these antiviral compounds have been licensed for children over 12 years old and only IFN-α as well as entecavir have been approved for a pediatric population aged between 2 and 18 years[ 24 , 26 ].…”