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JAC Advance Access published online on October 3, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm362
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading article

Treatment of children persistently infected with hepatitis B virus: seroconversion or suppression

Nicola Price and Elizabeth H. Boxall*

Health Protection Agency, West Midlands Public Health Laboratory, Heart of England NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK

* Corresponding author. E-mail: elizabeth.boxall{at}heartofengland.nhs.uk

We have reviewed the current strategies regarding the treatment of persistent hepatitis B virus (HBV) in children and compared these with adult strategies. The options for achieving suppression of viral DNA replication versus hepatitis B e antigen to antibody seroconversion have been evaluated. The results of studies in different geographical locations have been confounded by HBV genotypes, as it is now clear that some genotypes respond better to treatment than others. Consideration needs to be given as to whether optimal treatment strategies developed for adults are directly applicable to children. In children, early seroconversion to allow improved long-term outcomes should be considered rather than embarking on the long-term complexities of managing patients on a combination of antiviral drugs to achieve viral suppression.

Key Words: HBV , antiviral therapy , DNA replication


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