       Document 0119
 DOCN  M9640119
 TI    Chronic hepatitis in children.
 DT    9604
 AU    Maggiore G; Istituto di Clinica Pediatrica, Universita di Pisa, Italy.
 SO    Curr Opin Pediatr. 1995 Oct;7(5):539-46. Unique Identifier : AIDSLINE
       MED/96120879
 AB    Autoimmune hepatitis is an inflammatory disease of the liver of unknown
       etiology that progresses toward cirrhosis and liver failure and is
       generally responsive to immunosuppressive treatment. The presence of
       anti-smooth muscle antibodies with anti-actin specificity and of
       anti-liver kidney microsomal antibodies defines two distinct subgroups
       of the disease. An autoantibody against liver cytosolic antigens has
       recently been described. Management of autoimmune hepatitis relies on
       immunosuppressive therapy with steroids alone or combined with
       azathioprine. When the disease is poorly controlled, despite good
       patient compliance to therapy, cyclosporin should be recommended.
       Progressive liver disease in chronic hepatitis B in adults has been
       associated with the presence of precore mutants of hepatitis B virus. In
       children, the presence of precore mutants seems not to affect the rate
       of seroconversion to anti-hepatitis B e antigen. However, high viremic
       levels of precore mutants are associated with persistent viral
       replication and liver disease. Interferon alfa seems to be less
       effective in children than in adults in the treatment of chronic
       hepatitis B; however, it hastens the seroconversion rate to
       anti-hepatitis B e antigen, accelerating the spontaneous clearance of
       the virus in children with already low levels of viral replication.
       Blood transfusions, especially those received in the perinatal period,
       are the single most important source of infection with hepatitis C in
       childhood. HIV coinfection is a major risk factor for vertical
       transmission of hepatitis C virus in pregnant women. Chronic hepatitis C
       in children is usually an asymptomatic disease associated with mild to
       moderate fluctuation of aminotransferase activities and histologic
       features of mildly active hepatitis. Severe active hepatitis and
       cirrhosis are infrequent during childhood and adolescence. Interferon
       may have a place in the treatment of chronic hepatitis C in children.
 DE    Adult  Autoimmune Diseases/DRUG THERAPY/ETIOLOGY  Child  Chronic Disease
       Disease Transmission, Vertical  Female  *Hepatitis/DRUG THERAPY/ETIOLOGY
       Hepatitis B/THERAPY  Hepatitis C/THERAPY/TRANSMISSION  Human
       Immunosuppressive Agents/THERAPEUTIC USE  Interferon-alpha/THERAPEUTIC
       USE  Pregnancy  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

