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The management and treatment of chronic hepatitis B in Korean children

Korean Journal of Pediatrics 2007;50(9):823-834.
Published online September 15, 2007.
The management and treatment of chronic hepatitis B in Korean children
Byung-Ho Choe
Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
소아 만성 B형 간염의 관리와 치료
경북대학교 의과대학 소아과학교실
Byung-Ho Choe, Email: bhchoi@knu.ac.kr
Interferon (IFN) alpha has been the first line therapy of chronic hepatitis B in children, but HBeAg seroconversion occurred in 26% of treated children compared to 11% of controls in multinational randomized controlled study. Recently, lamivudine was shown to be a potent inhibitor of Hepatitis B virus (HBV) reproduction both in HBeAg positive and in HBeAg negative (the pre-core mutant form) chronic hepatitis in randomized studies worldwide. Lamivudine therapy led to considerable improvement in the seroconversion rate of HBeAg in children with chronic hepatitis B, though long-term therapy resulted in the expansion of lamivudine-resistant mutant viruses. Combination therapy with lamivudine plus alpha-IFN does not seem to improve HBe Ag seroconversion. Above all, the most effective way to prevent hepatitis B is universal HBV vaccination.
Key Words: Chronic Hepatitis B, Management, Treatment, Interferon, Lamivudine, Children

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