Viral hepatitis B and C in children

Viral hepatitis B and C are the cause of significant disease worldwide. Acute infection is more common with hepatitis B than C in childhood; but chronic asymptomatic infection leading to chronic liver disease and hepatocellular carcinoma is a considerable concern. The natural history of hepatitis B is well established in adults but the long-term outcome for children is still under debate. Following an acute infection, 90 % will recover spontaneously; but approximately 1 % of patients develop acute fulminant hepatitis requiring liver transplantation. The main source of infection in childhood is perinatal transmission, which is effectively prevented using vaccina-tion, antenatal screening and screening of blood products and organ donors. The vaccine is effective in 97 % of newborn infants and lasts for 10–15 years