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儿童慢性病毒性肝炎的治疗:现有治疗方法和未来展望。

Treatment of children with chronic viral hepatitis: what is available and what is in store.

机构信息

Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy.

出版信息

World J Pediatr. 2013 Aug;9(3):212-20. doi: 10.1007/s12519-013-0426-0. Epub 2013 Aug 9.

Abstract

BACKGROUND

At present, therapy of children with chronic hepatitis B and C is still based on few drugs, all burdened by a series of side-effects, unsatisfactory serum conversion rates, and/or drug-resistance. Moreover, selection of subjects to treat with conventional therapies is not univocal, especially during the pediatric age when the disease course is often mild with significant spontaneous seroconversion rate. Our review deals with pros and cons points when a physician decides to design a drug therapy for a child with chronic viral hepatitis, and different possible therapeutic opportunities.

METHODS

A literature search was performed through PubMed. The newest articles, reviews, systematic reviews, and guidelines were included in this review.

RESULTS

The management of children with viral hepatitis is still controversial over whom and when to treat and the use of drug(s). Novel therapeutic strategies have been evaluated only in clinical and preclinical trials involving, for instance, "therapeutic" vaccines. The data on safety and effectiveness of new drugs are also reviewed.

CONCLUSION

The results of reported studies confirmed that at least some of the new drugs, with greater efficacy and/or minor side-effects, will be used clinically.

摘要

背景

目前,儿童慢性乙型和丙型肝炎的治疗仍然依赖少数几种药物,这些药物都存在一系列副作用、血清转换率不理想和/或耐药性等问题。此外,选择接受常规治疗的患者并不明确,尤其是在儿科,疾病通常较轻,自发血清转换率较高。我们的综述讨论了医生在为慢性病毒性肝炎儿童设计药物治疗方案时的利弊权衡,以及不同的治疗机会。

方法

通过 PubMed 进行文献检索。本综述纳入了最新的文章、综述、系统评价和指南。

结果

儿童病毒性肝炎的管理仍然存在争议,例如,针对哪些患者以及何时进行治疗,以及药物的使用等问题。新型治疗策略仅在临床试验和临床前试验中进行了评估,例如“治疗性”疫苗。新药物的安全性和有效性数据也进行了综述。

结论

报告的研究结果证实,至少有一些新的药物将具有更高的疗效和/或更小的副作用,并将在临床上使用。

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