How is chronic hepatitis treated in children?

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

At the time of exacerbation of chronic hepatitis, the patient needs a bed rest. Expansion of the regime is carried out 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 diets is slightly reduced, and the carbohydrate content is increased in comparison with physiological needs. In cases of hepatic insufficiency, the amount of protein is halved.

Patients should be protected from the excess of any medicines, especially drugs that are rendered harmless by the liver.

With viral chronic hepatitis, a positive effect of treatment with interferon preparations has been established. The optimal preparation in children is considered to be viferon - genetically engineered recombinant a-2-interferon with vitamins E and C. Children under 4 years of age are given in a dose of 250 000 ME and children under 10 years - 500 000 ME (one candle) 2 times a day 5 -10 days and then 3 times a week for 3-6 months. Repeated courses of viferon - after 3 months. The scheme of an extended course of maintenance therapy with viferon 3 times a week for 12 months with hepatitis B and longer for delta infection and hepatitis C

In case of chronic hepatitis caused by viruses B, C, D, parenteral preparations of interferon-a-2a-interferon (roferon) and a-2b-interferon (intron A) are also used, and in addition interferon inducers (cycloferon).

With chronic hepatitis with moderate activity, phytotherapy (broths of immortelle, corn stigmas, trefoil, dandelion root, peppermint leaves, chamomile flowers or cholagogue tea), choleretics is shown.

In chronic hepatitis with a pronounced activity resort to means that improve the metabolism of the hepatic cell: essential, legaln, heptral, sirepare, karsila, siliboru, kokarboksilaz, vitamins E, B5, B6, B15, riboxin, cytochrome C, ATP, lipoic acid, lipid.

With autoimmune hepatitis, the administration of corticosteroids and immunosuppressants or cyclosporin A reduces the likelihood of cirrhosis.

Spa legenie children with chronic hepatitis performed in local health centers as well as resorts Zheleznovodsk, Yessentuki, Pyatigorsk lake Shir, Easty-su Morshyn et al. Contraindications are the presence of signs of active destructive and necrotic process in the liver or severe hepatic insufficiency .

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

Clinical follow-up of children with chronic hepatitis is performed by a pediatrician before the child is transferred to an adult polyclinic.

In the first 2 years after discharge from the hospital:

• examination of the doctor and biochemical blood tests (bilirubin level, transaminase activity, proteins and protein fractions) - once in 3 months;
• blood analysis, feces analysis for helminth eggs, consultation of an otolaryngologist (exclusion of chronic tonsillitis), dentist (exclusion of dental caries) - every 6 months;
• tjubazhi 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 water for 1 month (Slavyanovskaya, Essentuki No. 4, Arzni, Jermuk, Arshan, Sairme, Vytautas, Izhevskaya, Mirgorodskaya) - once in 6 months.

2 years after exacerbation:

• examination of a doctor, biochemical and clinical blood tests, specialist consultations - every 6 months;
• tjubazhi, phytotherapy and probiotics, multivitamin and mineral water courses - once in 6 months.

[1], [2], [3], [4], [5], [6], [7], [8],