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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

Hepatitis B virus infection in children: Antiviral therapy for children with a normal alanine aminotransferase level

DOI: 10.12449/JCH240504
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  • Corresponding author: FU Lei, fulei92@126.com (ORCID: 0000-0001-7550-1254)
  • Received Date: 2024-03-02
  • Accepted Date: 2024-03-24
  • Published Date: 2024-05-25
  • Chronic hepatitis B (CHB) is a major public health issue around the world, and there are currently about 2 million children with hepatitis B virus (HBV) infection in China. HBV infection in children tends to become chronic, leading to high risks of liver cirrhosis and liver cancer in adulthood. Traditionally, it is believed that children with HBV infection are mainly in the immune-tolerant phase and do not require antiviral therapy, and antiviral therapy is only initiated for CHB children who are in the immune-active phase or suffer from compensated or decompensated liver cirrhosis. More and more clinical studies on CHB in children have shown that CHB children tend to have a high response rate to antiviral therapy, especially interferon-based regimens, and young children are at the advantage of clinical cure; however, there are still controversies over whether antiviral therapy should be initiated for children with HBV infection who have a normal alanine aminotransferase (ALT) level and are in the immune-tolerant phase. This article reviews the features of children with HBV infection and the necessity of antiviral therapy for children with a normal ALT level, with a special focus on treatment timing.

     

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