How is chronic hepatitis in children treated?

Treatment of chronic hepatitis in children is carried out according to the same principles as in adults.

During an exacerbation of chronic hepatitis, the patient needs bed rest. The regimen is expanded gradually, as the general condition and functional capacity of the liver improve.

The diet depends on the stage of the disease. The amount of fat in the daily diet is somewhat reduced, and the carbohydrate content is increased compared to physiological needs. In cases of liver failure, the amount of protein is halved.

Patients should be protected from excess of any medications, especially drugs that are detoxified by the liver.

In viral chronic hepatitis, a positive effect of treatment with interferon preparations has been established. The optimal drug for children is considered to be Viferon - a genetically engineered recombinant a-2-interferon with vitamins E and C. Children under 4 years old are administered at a dose of 250,000 IU and children under 10 years old - 500,000 IU (one suppository) 2 times a day for 5-10 days and then 3 times a week for 3-6 months. Repeated courses of Viferon - after 3 months. A scheme for an extended course of maintenance therapy with Viferon 3 times a week for 12 months for hepatitis B and a longer one for delta infection and hepatitis C has been proposed.

For chronic hepatitis caused by viruses B, C, D, parenteral interferon preparations are also used - a-2a-interferon (roferon) and a-2b-interferon (intron A), as well as interferon inducers (cycloferon).

In case of chronic hepatitis with moderate activity, herbal therapy is indicated (decoctions of immortelle, corn silk, trefoil, dandelion root, peppermint leaves, chamomile flowers or choleretic tea), choleretics.

In chronic hepatitis with pronounced activity, they resort to agents that improve liver cell metabolism: Essentiale, Legalon, Heptral, Sirepar, Carsil, Silibor, Cocarboxylase, vitamins E, B5, B6, B15, Riboxin, Cytochrome C, ATP, Lipoic acid, Lipamide.

In autoimmune hepatitis, the administration of corticosteroids and immunosuppressants or cyclosporine A reduces the likelihood of developing liver cirrhosis.

Sanatorium and resort treatment of children with chronic hepatitis is carried out in local sanatoriums, as well as at resorts in Zheleznovodsk, Essentuki, Pyatigorsk, Lake Shira, Isti-su, Morshin, etc. Contraindications include the presence of signs of an active destructive-necrotic process in the liver or severe liver failure.

Prevention. Currently, active prevention of hepatitis A and B has been developed. Vaccines against hepatitis C, D, E, G, F have not yet been created.

Outpatient monitoring of children with chronic hepatitis is carried out by a pediatrician until the child is transferred to an adult clinic.

In the first 2 years after discharge from hospital:

• medical examination and biochemical blood tests (bilirubin level, transaminase activity, proteins and protein fractions) - once every 3 months;
• blood test, stool test for helminth eggs, consultation with an otolaryngologist (to rule out chronic tonsillitis), dentist (to rule out dental caries) - once every 6 months;
• tubages 2 times a week for 1 month in combination with herbal medicine and probiotics (lactobacterin or bifidumbacterin), two-week courses of vitamins (C, A, B15, B5, B6, etc.) - 1 time in 4 months;
• drinking mineral waters for 1 month (Slavyanovskaya, Essentuki No. 4, Arzni, Jermuk, Arshan, Sairme, Vytautas, Izhevskaya, Mirgorodskaya) - once every 6 months.

2 years after the exacerbation:

• medical examination, biochemical and clinical blood tests, specialist consultations - once every 6 months;
• tubages, herbal medicine and probiotics, courses of multivitamins and mineral waters - once every 6 months.

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