hepatitis%20-%20viral%20(pediatric)
HEPATITIS - VIRAL (PEDIATRIC)
The majority of acute viral hepatitis infections are asymptomatic or they can cause an anicteric illness that may not be diagnosed as hepatitis.
Hepatitis A generally causes minor illness in childhood with >80% of infections being asymptomatic. Jaundice and intestinal symptoms usually resolve 2-3 weeks after onset. A patient is infectious 1-2 weeks prior to the clinical illness.
Hepatitis B, C, & D may be symptomatic depending on the mode and time of transmission.
Hepatitis A is predominantly transmitted through oral-fecal by person-person direct transmission and contaminated material or food.
Hepatitis B is transmitted perinatal, horizontal spread, percutaneous, sexual, close person-to-person contact.
Majority of hepatitis C infections are identified in children with repeated exposure to blood products.
Hepatitis D is route of transmission is through sexual, percutaneous especially IV drug use.
Hepatitis E is transmitted primarily through contaminated drinking water and oral-fecal transmission.
  1. Entecavir (Baraclude) for chronic hepatitis B. Med Lett Drugs Ther. 2005 Jun;47(1210):47-48. http://www.ncbi.nlm.nih.gov/pubmed/?term=15933618. PMID: 15933618
  2. Chang MH. Hepatitis B virus infection. Feb 28, 2007. Semin Fetal Neonatal Med. 2007 Jun;12(3):160-167. http://dx.doi.org/10.1016/j.siny.2007.01.013. PMID: 17336170
  3. Dienstag JL, McHutchison JG. American Gastroenterological Association medical position statement on the management of hepatitis C. Gastroenterology. 2006 Jan;130(1):225-230. doi: 10.1053/j.gastro.2005.11.011. PMID: 16401485
  4. Gish RG. Current treatment and future directions in the management of chronic hepatitis B viral infection. Clin Liver Dis. 2005 Nov;9(4):541-565. doi:10.1016/j.cld.2005.08.005. PMID: 16207563
  5. Gjorup IE, Skinjoh P. New aspects on the natural history of chronic hepatitis B infection. Scand Infect Dis. 2003;35(11-12):808-813. PMID: 14723354
  6. Kim AI, Saab S. Treatment of hepatitis C. Am J Med. 2005 Aug;118(8):808-815. http://dx.doi.org/10.1016/j.amjmed.2005.01.073. PMID: 16084169
  7. Liaw, YF, Leung N, Guan R, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2005 update. Liver Int. 2005 Jun;25(3):472-489. PMID: 15910483
  8. Rudolph A, Wang G, Sherman KE, et al. Therapeutic strategies for liver disease. Gastroenterol Hepatol. 2006 Jul;2(7):003-12.
  9. Radcliffe K. European STD guidelines. Int J STD AIDS. 2001 Oct;12(Suppl 3):1-102. http://www.iusti.org. PMID: 11589789
  10. Strader DB, Wright T, Thomas Dl, Seef LB for the American Association for the Study of the Liver. AASLD Practice Guideline. Diagnosis, management, and treatment of hepatitic C. Hepatol. 2004 Apr;39(4):1147-1171. http://onlinelibrary.wiley.com/doi/10.1002/hep.20119/pdf. PMID: 15057920
  11. Centers for Disease Control and Prevention, Workowski KA, Berman SM. HPV infection and genital warts. Sexually transmitted diseases treatment guidelines 2006. MMWR. 2006;55(RR-11):62-67. PMID: 16888612
  12. MedWormhttp://www.medworm.com/rss/index.php/Gastroenterology/17/http://www.medworm.com/rss/medicalfeeds/specialities/Gastroenterology.xml
  13. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  14. Australian National Council on AIDS, Hepatitis C and Related Diseases (ANCAHRD) Hepatitis C Committee and Clinical Trial and Research Committee (CTARC). A model of care for the management of hepatitis C infection in adults. http://www.bvsde.paho.org/. Jul 2003.
  15. Ministry of Health Singapore, Gastroenterological Society of Singapore, National Medical Research Council. Clinical practice guidelines: chronic hepatitis B infection. http//www.moh.gov.sg. Mar 2003.
  16. Cramp M, Rosenberg W. British Society for Gastroenterology guideline on the treatment of hepatitis C incorporating the use of pegylated interferons. http://www.bsg.org.uk. 2001.
  17. College of Paediatrics, Academy of Medicine Malaysia. Malaysian immunisation manual. http://www.acadmed.org.my/. 2001.
  18. Liberek A, Luczak G, et al. Management of chronic hepatitis B in children. http://www.medknow.com.
  19. Scottish Intercollegiate Guidelines Network. Management of hepatitis C: a national clinical guideline. SIGN Web Site. http://www.sign.ac.uk/pdf/sign92.pdf. Dec 2006.
  20. Scientific Working Group on Viral Hepatitis Prevention, Dept of Health. Recommendations on hepatitis B vaccination regimens in Hong Kong. Jan 2001
  21. Wolf DC. Viral hepatitis. eMedicine. http://www.emedicine.com/. 2004.
  22. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J Hepatol. 2014 Feb;60(2):392-420. http://www.easl.eu. Accessed 20 Mar 2014. PMID: 24331294
  23. Centers for Disease Control and Prevention. Testing for HCV infection: an update of guidance for clinicians and laboratorians. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/pdf/wk/mm62e0507a2.pdf. 2013. Accessed 07 Apr 2014.
  24. National Institute for Health and Care Excellence (NICE). CG165: Diagnosis and management of chronic hepatitis B in children, young people and adults. National Institute for Health and Care Excellence (NICE) Web Site. http://www.nice.org.uk/nicemedia/live/14191/64248/64248.pdf. Jun 2013.
  25. Lok AS, McMahon BJ for the American Association for the Study of the Liver. AASLD Practice Guideline: Chronic hepatitis B. Hepatol. 2007 Feb;45(2):507-539. http://onlinelibrary.wiley.com/doi/10.1002/hep.21513/epdf. PMID: 17256718
  26. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137. http://www.cdc.gov/. Accessed 17 Aug 2016. PMID: 26042815
  27. World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. WHO. http://www.who.int/. Mar 2015. Accessed 08 Jul 2015.
  28. Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016 Jan;10(1):1-98. doi: 10.1007/s12072-015-9675-4. Accessed 05 Aug 2016. PMID: 26563120
  29. American Association for the Study of Liver Diseases/Infectious Disease Society of America HCV Guidance Panel. AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. AASLD website. http://hcvguidelines.org/sites/default/files/HCV-Guidance_July_2016_b.pdf. Jul 2016.
  30. Jensen MK, Balistreri WF. Viral hepatitis. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier Inc; 2016:1942-1853.e1.
  31. Nel E, Sokol RJ, Comparcola D, et al. Viral hepatitis in children. J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):500-555. doi: 10.1097/MPG.0b013e318272aee7. PMID: 22983372
  32. Sokal EM, Paganelli M, Wirth S, et al; European Society of Pediatric Gastroenterology, Hepatology and Nutrition. Management of chronic hepatitis B in childhood: ESPGHAN clinical practice guidelines: consensus of an expert panel on behalf of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition. J Hepatol. 2013 Oct;59(4):814-829. doi: 10.1016/j.jhep.2013.05.016. PMID: 23707367
  33. Terrault NA, Bzowej NH, Chang KM, Hwang JP, Jonas MM, Murad MH. Practice guideline: AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2015 Nov;63(1):261-283. http://onlinelibrary.wiley.com/doi/10.1002/hep.28156/epdf.
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
2 days ago
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.
Tristan Manalac, 3 days ago
In patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PPCI), admission Killip classification and creatinine and troponin levels are important cardiac mortality predictors, according to a recent Singapore study.