nan Rukunuzzaman

Management of Chronic HBV Infection in Children

Hepatitis B virus (HBV) infection is prevalent worldwide. About ten million people are chronically infected with HBV in Bangladesh, and it is possible that most infections occur during childhood. Overall prevalence is about 3% in Bangladesh. Chronic hepatitis B infection evolves through five phases. Most of the children belong to the immune-tolerant phase. Treatment of chronic hepatitis B is difficult. The goals of therapy are to reduce viral replication, to minimize liver injury, to reduce consequence of liver injury like cirrhosis and hepatocellular carcinoma, and to reduce infectivity of HBV. Treatment should be considered in chronic hepatitis B if patients have persistently elevated ALT of more than twice the normal range and evidence of viral replication. Seroconversion occurs in about 17–32% of cases if treated with oral nucleot(s)ide analogue and in about 58% of cases if treated with interferon. Risk factor identification and prevention of HBV infection is the logical and rational approach.