Canadian Association for the Study of the Liver
Hepatitis B in children
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In addition, most infants and young children infected with hepatitis B have normal aminotransferases and are not candidates for therapy (8,43)
Children who are first infected at ages over 7 years of age have a low risk of developing chronic disease. The prognosis of hepatitis B in children is generally good, cirrhosis and hepatocellular carcinoma are only rarely seen in the childhood years. Spontaneous seroconversion from HBeAg to anti-HBe antibody occurs in between 6-12% of infected children per year. In randomized controlled trials treatment with alpha-interferon in children resulted in 35% clearance of HBV DNA and HBeAg (11% in controls) and 7% clearance of HBsAg (1% in controls) (44). Optimal treatment is between 3-6 Mu/m2 of interferon TIW for 6 months. The indications for treatment are similar to those in adults. There is no information on the use of lamivudine in children. Normally treatment should not begin before two years of age, because of the side effects of alpha-interferon. In older children the side effects of interferon appear to be well-tolerated. Weight loss can be offset by dietary interventions.