Browse the corpus

©2013 UpToDate ® Print Email Algorithm for selection of children for HBV antiviral treatment HBV: hepatitis B virus; HBsAg: hepatitis B s antigen; ALT: alanine aminotransferase; HBeAg: hepatitis B e antigen; HCC: hepatocellular carcinoma; IU: international unit. * The upper limit of normal (ULN) for ALT in children is not well established; it varies with the testing laboratory and the age of the child. For the purposes of HBV monitoring, we suggest that a child's ALT be considered elevated if it is greater than the ULN established by the testing laboratory, or >40 IU/L, whichever is lower. For older adolescents, we suggest using 30 IU/L for males and 19 IU/L for females (the same ULN used for adults). • Because of limited options with current drugs, it may be appropriate to treat older adolescents with immune active HBV with one of these newer agents using adult protocols, or to enroll children in clinical trials of newer agents, or even withhold treatment until the patient is old enough to be treated as adults (if liver fibrosis is only mild). Jonas MM, Block JM, Haber BA, et al. Treatment of children with chronic hepatitis B virus infection in the United States: Patient selection and therapeutic options. Hepatology 2010. Copyright © 2010 American Association for the Study of Liver Diseases. Reproduced with permission from John Wiley & Sons.