基于国际和国家指南的儿童慢性病毒性乙型肝炎的当前管理策略。

Journal of mother and child Pub Date : 2023-08-31 eCollection Date: 2023-06-01 DOI:10.34763/jmotherandchild.20232701.d-23-00006
Inna M Nesina, Tetyana O Kryuchko, Olha A Poda, Olha Ya Tkachenko, Nataliia V Kuzmenko, Liudmyla M Bubyr
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引用次数: 0

摘要

背景:尽管实施了现代治疗和预防方案,但儿童慢性病毒性乙型肝炎病程的特殊性导致了一个重要的医疗和社会保健问题。乙型病毒性肝炎感染发展和进展的致病机制、隐性诊断不良形式的存在、不可能完全消除病毒以及儿童免疫反应的特异性仍然没有完全解决科学问题。材料和方法:本综述的目的是根据国际和国家指南,审查目前儿童慢性乙型肝炎的诊断和治疗策略。结果:对病毒性乙型肝炎感染过程和发病机制的现代指南的详细分析证实了一个事实,即慢性乙型肝炎的特征是病毒免疫系统和患者之间的复杂相互作用,其动态平衡不仅负责慢性病毒性乙型肝炎感染的各个阶段,而且导致抗病毒治疗的结果。结论:尽管引入了儿童乙肝疫苗接种,但乌克兰儿童的乙肝病毒疫苗接种水平仍然不足,这导致了感染的进一步传播。目前可用的抗病毒药物可以为数量有限的患者提供病毒性乙型肝炎感染的功能性治疗,但今天乌克兰的现实已经导致患者治疗和监测方法的改变,这可能会对世界卫生组织全球预防战略的关键目标的实施产生负面影响,病毒性肝炎的诊断和治疗。
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A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines.

Background: Peculiarities of the course of chronic viral hepatitis B in children cause an important medical and social problem of health care, despite the implementation of modern treatment and prevention protocols. Pathogenetic mechanisms of the development and progression of viral hepatitis B infection, the presence of occult poorly diagnosed form, the impossibility of completely eliminating the virus and the specificity of the immune response in children are still not fully solved scientific problems.

Material and methods: The aim of this review is to examine current strategies for the diagnosis and treatment of chronic hepatitis B in children, based on international and national guidelines.

Results: A detailed analysis of modern guidelines on the course and pathogenesis of viral hepatitis B infection confirms the fact that chronic hepatitis B is characterised by a complex interaction between the immune system of the virus and the patient, whose dynamic balance is not only responsible for the various phases of chronic viral hepatitis B infection but also leads to the result of antiviral treatment.

Conclusion: Despite the introduction of vaccination of children against hepatitis B, the level of viral hepatitis B vaccination of children in Ukraine remains insufficient, which leads to the further spread of the infection. Currently available antiviral drugs can provide functional treatment of viral hepatitis B infection in a limited number of patients, but today's Ukrainian realities have caused a change in approach to the treatment and monitoring of patients, which may negatively affect the implementation of the key goals of the World Health Organization Global Strategy on the prevention, diagnosis and treatment of viral hepatitis.

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