EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.22759

Diagnosis, management, and treatment of hepatitis C: An update

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2001.29401

Chronic hepatitis B

Epidemiology of Viral Hepatitis and Hepatocellular Carcinoma

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.23190

Chronic hepatitis B: Update 2009

Delta infection in children.

Sir: Recent studies have shown that primary hepatocellular carcinoma (PHC) in childhood is aetiologically related to hepatitis B virus (HBV) infection [1]. So far, there are no prospective studies, however, of the development of PHC in children with chronic type B hepatitis, and little is known about risk factors and early diagnosis of the turnout in this population. In 1976 in Padua we started a longitudinal study of biopsy-proven chronic type B hepatitis, and since 1985 we have introduced alpha-fetoprotein determination among routine tests to be performed every 6 months during follow up. Overall 103 children, including 5 with histological features of cirrhosis, have been followed up for a mean period of 6.1 _+ 2.9 years (mean + SD). During the observation period none of the patients had signs of liver failure or portal hypertension, but one out of five children with cirrhosis developed high alpha-fetoprotein levels and was found to have PHC, before the appearance of any clinical symptoms. We report here the clinical history of this patient. The first child of apparently healthy, non-consanguineous parents, was born in 1978 after an uncomplicated gestation and full-term delivery. He was found to be HBsAg positive at the age of 15 months when his younger brother died of fulminant hepatitis B. At this time his mother was also found to be HBsAg positive. The boy came to our attention at the age of 24 months: he was a well grown asymptomatic child with moderate hepatomegaly and a threefold increase of alanine aminotransferase (ALT) levels. Liver function tests were normal, hepatitis Be antigen (HBeAg) was negative while antiHBe was positive. Six months later liver biopsy showed features of chronic active hepatitis with associated cirrhosis, while HBV DNA was undetectable in serum. By the age of 36 months ALT had become normal and 15 months later liver biopsy was consistent with inactive cirrhosis. Since then the patient has remained asymptomatic, with normal ALT levels. He was followed at regular intervals up to October 1985 when alpha4etoprotein levels were normal. During subsequent years we received information about the child's health but could not see the patient until February 1989.

Flavia Bortolotti

Papers

Delta infection in children.

Chronic type B hepatitis and primary hepatocellular carcinoma in children.

ANTIBODY TO THE POLYALBUMIN (pHSA) RECEPTOR ON HEPATITIS B VIRUS IN ACUTE INFECTION AND IN VACCINE RECIPIENTS

Relevance of serum HBV-DNA in acute and chronic hepatitis type B

HCV genotypes and hepatitis C in children.