Chronic Hepatitis B in children and adolescents: a longitudinal assessment.

Chronic Hepatitis B in children is a problem alla over the world; paediatrica data are limited. The authors describe clinical, biochemical, virological and imaging data of a cohort of paediatric patients with chronix Hepatitis B infection who attended tha Paediatric Infection Disease Unit of Luigi Sacco Hospital, University of Milan. We followed 13 children and adolescents, all of whom were vertically-infected. Every 6 months patients underwent laboratory assessment and virological examination. seum IgA, IgM, IgG, lipid profile, coagulation assessment, ferritin, alfa-phetoprotein were tested once a year. Lievr ultrasound examination using Esoate Mylab50 and transient elastography usinf Fibroscan was performed once a year. 11 children of of 13 were HBeAg positive; only 1 patient was anti-HBeAg positive. AST and ALT values were elevated in 7/13 and 5/13 respectively. During the follow-up 2 patinets (15%) seroconverted to anti-HBeAg. the mosto common picture at hepatic ultrasoud was grade I steatosis and 2 children showed mild hepatomegaly. the transient elastography evaluation, performed in 7 cases, showed mild increment of liver stiffness values in all cases. The median stiffness was 5.2 KPa. The dicision about when and how star antiviral therapy in children is still a controversial issue; however an early treatment would have tha purpose to reduce viral replication and infectivity, and prevent long-term complications.