SPONTANEOUS COURSE AND TREATMENT OF CHRON IC VIRAL-HEPATITIS IN CHILDREN

In Germany chronic viral hepatitis B, D, and C in children are of some epidemiological significance. The most frequent diagnosis is chronic hepatitis B. Own investigations referring to the spontaneous course of the disease showed an annual seroconversion rate of 7.5% for children with postnatal infection and 2.5% for patients with vertical transmis sion. HBsAg carriers with a cured oncologic disease showed a seroconve rsion rate of 2.7% per year. Moreover, a higher incidence of seroconve rsion to anti-HBe was found in children with a high inflammatory activ ity in the liver tissue. Alpha-interferon represents an effective trea tment, yielding a seroconversion rate from HBeAg to anti-HBe of about 40% within one year after treatment, 6-8% have the chance to lose HBsA g. An associated hepatitis D worsens the prognosis during long term fo llow-up. Because of the low response rate in these cases alpha-interfe ron is not generally recommended. Chronic hepatitis C in childhood occ urs mostly in children with transfusions of blood or blood products in their history. The spontaneous course seems to be less progressive co mpared to adults. At present trials with alpha-interferon in children with chronic hepatitis C are performed.