<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Peculiarities of the course of chronic viral hepatitis B in children cause an important medical and social problem of health care, despite the implementation of modern treatment and prevention protocols. Pathogenetic mechanisms of the development and progression of viral hepatitis B infection, the presence of occult poorly diagnosed form, the impossibility of completely eliminating the virus and the specificity of the immune response in children are still not fully solved scientific problems.</p>
</sec>
<sec><h3>Material and Methods</h3>
<p>The aim of this review is to examine current strategies for the diagnosis and treatment of chronic hepatitis B in children, based on international and national guidelines.</p>
</sec>
<sec><h3>Results</h3>
<p>A detailed analysis of modern guidelines on the course and pathogenesis of viral hepatitis B infection confirms the fact that chronic hepatitis B is characterised by a complex interaction between the immune system of the virus and the patient, whose dynamic balance is not only responsible for the various phases of chronic viral hepatitis B infection but also leads to the result of antiviral treatment.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Despite the introduction of vaccination of children against hepatitis B, the level of viral hepatitis B vaccination of children in Ukraine remains insufficient, which leads to the further spread of the infection. Currently available antiviral drugs can provide functional treatment of viral hepatitis B infection in a limited number of patients, but today's Ukrainian realities have caused a change in approach to the treatment and monitoring of patients, which may negatively affect the implementation of the key goals of the World Health Organization Global Strategy on the prevention, diagnosis and treatment of viral hepatitis.</p>
</sec>
</abstract>

Background
Peculiarities of the course of chronic viral hepatitis B in children cause an important medical and social problem of health care, despite the implementation of modern treatment and prevention protocols. Pathogenetic mechanisms of the development and progression of viral hepatitis B infection, the presence of occult poorly diagnosed form, the impossibility of completely eliminating the virus and the specificity of the immune response in children are still not fully solved scientific problems.

Material and Methods
The aim of this review is to examine current strategies for the diagnosis and treatment of chronic hepatitis B in children, based on international and national guidelines.

Results
A detailed analysis of modern guidelines on the course and pathogenesis of viral hepatitis B infection confirms the fact that chronic hepatitis B is characterised by a complex interaction between the immune system of the virus and the patient, whose dynamic balance is not only responsible for the various phases of chronic viral hepatitis B infection but also leads to the result of antiviral treatment.

Conclusion
Despite the introduction of vaccination of children against hepatitis B, the level of viral hepatitis B vaccination of children in Ukraine remains insufficient, which leads to the further spread of the infection. Currently available antiviral drugs can provide functional treatment of viral hepatitis B infection in a limited number of patients, but today's Ukrainian realities have caused a change in approach to the treatment and monitoring of patients, which may negatively affect the implementation of the key goals of the World Health Organization Global Strategy on the prevention, diagnosis and treatment of viral hepatitis.

A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines

Journal of Mother and Child

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Peculiarities of the course of chronic viral hepatitis B in children cause an important medical and social problem of health care, despite the...

HBV phases	HBeAg+infection^/Immune-tolerant phase^*	HBeAg+ hepatitis^/Immune-active phase^*	HBeAg−infection^/Inactive carrier/immune-control phase^*	HBeAg−hepatitis^/Immune-escape phase^*	HBsAg−infection^/Occult HBV infection (anti-HBc-positive)^*

Indicators
Serum HBV DNA	>10 · IU/ml	>2000 IU/ml (constantly raised or fluctuating)	<2000 IU/mL	>2000 IU/mL	undetectable
ALT	normal	elevated	normal	elevated	normal
HBeAg	positive	positive	negative	negative	negative
HBsAg	high	high/intermediate	low	intermediate	negative
cccDNA	+++++	+++++	++	+++	+
Integrated HBV DNA	+++	++++	+++	++++	+
Liver disease (Necro-inflammatory changes)	none/minimal	moderate to severe	none	moderate to severe	none
Progression to cirrhosis	none	possible	none	more rapid than in other phases	none
Treatment	not generally indicated	may be indicated	not indicated	may be indicated	not indicated

A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines

Article Category: Systematic review

Online veröffentlicht: 31. Aug. 2023

Seitenbereich: 134 - 141

Eingereicht: 04. Jan. 2023

Akzeptiert: 23. Juni 2023

DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-23-00006

Schlüsselwörter
children, hepatitis B virus, chronic hepatitis B, diagnosis, treatment, management, prevention

© 2023 Inna M. Nesina et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Phases in natural history of chronic hepatitis B virus infection

A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines

Article Category: Systematic review

Online veröffentlicht: 31. Aug. 2023

Seitenbereich: 134 - 141

Eingereicht: 04. Jan. 2023

Akzeptiert: 23. Juni 2023

DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-23-00006

Schlüsselwörterchildren, hepatitis B virus, chronic hepatitis B, diagnosis, treatment, management, prevention

© 2023 Inna M. Nesina et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Phases in natural history of chronic hepatitis B virus infection

Schlüsselwörter
children, hepatitis B virus, chronic hepatitis B, diagnosis, treatment, management, prevention