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介绍
There are several published national andinternational guidelines regarding the management of adults with chronichepatitis B virus (HBV) infection,1–4 but standards for the treatment of children are still evolving.
The decision to treat involves numerousfactors such as the age of the child, the severity of liver disease, medicalcofactors, and family history of liver disease or liver cancer.
In addition to determining whom to treat, andwhen and for how long they should be treated, a particular challenge forpractitioners is the limited number of drugs that have been studied and labeledfor use in children.
Previously,an expert panel of nationally recognized pediatric liver specialists convenedby the Hepatitis B Foundation in November 2008 called for more consistentmonitoring and referral of children chronically infected with HBV, emphasizingthat any child with elevated serum alanine aminotransferase (ALT) levels and/orelevated alpha-fetoprotein (AFP) levels and/or a family history of liverdisease or liver cancer should be referred to a pediatric liver specialist.5
The panel assembled for a second meeting on August 11, 2009, toreview the status of clinical practice relative to the therapeutic optionsavailable for children, and to highlight gaps in knowledge and areas for futurestudy. The following is based on consensus of expert opinion andpublished evidence when available.
目前存在已经发表了的国内和国际上的用于控制成年慢性HBV感染的指导方案1-4，但是用于治疗儿童的标准还在不断的更新中。决定治疗需要考虑很多因素，比如说小孩的年龄，肝病的严重性，医疗辅助因素（cofactors）,家庭的肝脏疾病或者肝癌历史。
除了决定谁需要治疗，什么时候和如何治疗他们之外，对于参于者，一个特殊的挑战是批准用于治疗儿童的药物十分有限。
在2008年11月份，由乙肝基金会召集的全国知名的儿童肝病专家组成的专家座谈组来探讨更为一致的观察和治疗安排儿童慢性HBV感染，强调如果有升高的转氨酶水平（ALT）或者升高的甲胎蛋白（AFP）或者有家族肝病或者肝癌历史的患者必须安排到一个儿童肝病专家进行治疗。5
这个座谈组在2009年8月11号举办了第二次会议，讨论了目前临床用于儿童的治疗方案的现状，并且强调了目前知识的断层和将来研究的领域。下面的内容是基于专家的一致意见和已知发表的证据编写的。 | 
发表于 2011-7-19 15:52
atient Selection and Therapeutic Options
