Tenofovir Disoproxil Fumarate Treatment for Pediatric Patients with Perinatally
Acquired Chronic Hepatitis B
Hepatitis B Virus is an important worldwide cause of chronic liver disease in
children. In endemic areas, perinatal transmission accounts for the majority
of infections.
After exposure, the risk of developing chronic hepatitis B is highest during
the first year of life and in children infected before the age of 6 years.
During childhood CHB is usually asymptomatic, which has led to the recommendation
not to treat perinatally acquired CHB.
But once adulthood is reached, the end result can be cirrhosis, hepatocellular
carcinoma and increased mortality.
A search for means to prevent this progression is important.
As persistent HBV replication is directly related to disease progression
and complications, it may be reasonable to commence early preventative
measures.
Evidence from adult studies demonstrates that effective viral suppression
slows disease progression, promotes histological regression and may
lead to reversal of cirrhosis.
Tenofovir Disoproxil Fumarate, a nucleotide analogue,
is approved for the treatment of CHB in the United
States. A randomized controlled trial showed that TDF treatment
was safe and well tolerated in adolescents with a low incidence
of adverse events, and with no resistant HBV mutations.
The primary end point was an HBV DNA level below
the lower limit of detection by 72 weeks of treatment.
Response was compared between patients who had immune active hepatitis
and those who were in the immune tolerant phase.
Secondary end points included a normal ALT serum level,
HBeAg and HBsAg clearance and antibody seroconversion
by the end of the study.
Gastro Open J. 2015; 1(4): 94-99. doi: 10.17140/GOJ-1-116
