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基于国际和国内指南的儿童慢性乙型肝炎病毒感染的现行管理策略。

A Current Management Strategy for Children with Chronic Viral Hepatitis B, Based on International and National Guidelines.

机构信息

Department of Pediatrics No. 2, Poltava State Medical University, Poltava, Ukraine.

出版信息

J Mother Child. 2023 Aug 31;27(1):134-141. doi: 10.34763/jmotherandchild.20232701.d-23-00006. eCollection 2023 Jun 1.

Abstract

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.

摘要

背景

儿童慢性乙型病毒性肝炎病程的特殊性,使得其成为医疗保健方面一个重要的医学和社会问题,尽管已经实施了现代治疗和预防方案。乙型肝炎病毒感染的发病机制和进展、隐匿性诊断困难的形式的存在、完全消除病毒的可能性以及儿童的免疫反应特异性等问题仍然是尚未完全解决的科学问题。

材料和方法

本综述旨在根据国际和国家指南,探讨儿童慢性乙型肝炎的诊断和治疗的现行策略。

结果

对乙型肝炎病毒感染的病程和发病机制的现代指南的详细分析证实了这样一个事实,即慢性乙型肝炎的特点是病毒和患者的免疫系统之间的复杂相互作用,其动态平衡不仅负责慢性乙型肝炎感染的各个阶段,而且还导致抗病毒治疗的结果。

结论

尽管已经为儿童接种乙型肝炎疫苗,但乌克兰儿童的乙型肝炎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乙型肝炎病毒感染的功能治疗提供有限数量的患者,但目前乌克兰的现实情况已经导致了对患者治疗和监测方法的改变,这可能对世界卫生组织全球预防、诊断和治疗病毒性肝炎战略的关键目标的实施产生负面影响。

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