[An etiopathogenic and therapeutic update in chronic viral hepatitis in children].

Abstract

The author presents the new prospects in the treatment of the chronic viral hepatitis in children, which is an up-to-date-problem in the last decade. There are emphasized the present aspects concerning the etiopathogenesis of the disease, which represent a constellation of achievements as a scientific foundation for the therapy: new notions about the viral genome, the mutant viruses, the host's cell-mediated immunity. There are reminded the classifications of the chronic hepatitis and especially the new one of the chronic type B hepatitis, the carries state risks, the vertical transmission from mother to child as an epidemiological source, valid in our country, too. There are specified the findings of the inefficiency and the contraindication of the cortisone and immunosuppressive therapy in patients with proved viral markers (the improvement of the HBV replication and thus, worsening the disease). The present and the future therapy is represented by the antiviral and immunomodulator drugs (alfa-IFN); there are presented the doses, the mode of administration, the predictive and responsivity factors, as well as the combined therapy (prednisone and antivirals). There is concluded that the passive and active immunoprophylaxis in the newborns of HBs Ag-positive mothers in the replicative phase is a great necessity.