Treatment of children with chronic viral hepatitis: what is available and what is in store

Pietro Vajro, Claudio Veropalumbo, Sergio Maddaluno, Mariacarolina Salerno, Giancarlo Parenti, Claudio Pignata

Baronissi, Italy

Author Affiliations: Department of Medicine and Surgery, University of Salerno, Baronissi (Salerno), Italy (Vajro P); Department of Translational Medical Sciences, Pediatrics, University of Naples "Federico II", Naples, Italy (Veropalumbo C, Maddaluno S, Salerno M, Parenti G, Pignata C)

Corresponding Author: Pietro Vajro, Chair of Pediatrics, Department of Medicine and Surgery, University of Salerno, Via Allende 84081, Baronissi (Salerno), Italy (Tel: +39-089-672409; Email: pvajro@unisa.it)

doi: 10.1007/s12519-013-0426-0

Background: At present, therapy of children with chronic hepatitis B and C is still based on few drugs, all burdened by a series of side-effects, unsatisfactory serum conversion rates, and/or drug-resistance. Moreover, selection of subjects to treat with conventional therapies is not univocal, especially during the pediatric age when the disease course is often mild with significant spontaneous seroconversion rate. Our review deals with pros and cons points when a physician decides to design a drug therapy for a child with chronic viral hepatitis, and different possible therapeutic opportunities.

Methods: A literature search was performed through PubMed. The newest articles, reviews, systematic reviews, and guidelines were included in this review.

Results: The management of children with viral hepatitis is still controversial over whom and when to treat and the use of drug(s). Novel therapeutic strategies have been evaluated only in clinical and preclinical trials involving, for instance, "therapeutic" vaccines. The data on safety and effectiveness of new drugs are also reviewed.

Conclusion: The results of reported studies confirmed that at least some of the new drugs, with greater efficacy and/or minor side-effects, will be used clinically.

Key words: children; hepatitis B; hepatitis C; therapy

World J Pediatr 2013;9(3):212-220