Treatment of Chronic Hepatitis B and C in Children

Giuseppe Indolfi; Alessandro Nesi; Massimo Resti


Future Virology. 2012;7(10):955-972. 

In This Article

Future Perspective

In children with chronic hepatitis B, well-performed randomized controlled trials are needed to evaluate the efficacy of combined treatment of one or more antivirals with or without interferon (in the pegylated form). The results of similar studies in adults did not show a difference in sustained off-treatment virologic response and, so far, combinations are not recommended.[13,28] On the other hand, combination therapies have been proven to be more effective than monotherapy in the treatment of HIV and HCV infections, and combination therapy seems still to be a logical approach and a promising research area.

The important progress made in the development of new therapies in adults with genotype 1 infection is encouraging. Strategies in current clinical trials focus on the evaluation of different direct antiviral agents. The availability of numerous drugs belonging to different classes stimulates combination trials with multiple direct antiviral agents and with compounds targeting host cell factors aiming for interferon-free, all-oral anti-HCV therapy.[68] The possibility of both interferon-based and interferon-free regimens in combination with new specific inhibitors or direct antiviral agents active against hepatitis C seems realistic and suggests a conservative approach in children (future adults) with chronic genotype 1 infection.