Hepatitis A, B und C im Kindesalter

Hepatitis A, B, and C in children can raise diagnostic and therapeutic problems. Hepatitis A is a self limited infection with a fecal-oral transmission route. In children the clinical course is often asymptomatic or unspecific. The rate of icteric hepatitis A is growing with increasing age of the patient at time of infection. The prognosis is excellent in children. Active immunization against hepatitis A prevents infection. Hepatitis B is a more complex disease as chronic liver disease, aggressive hepatitis, and lack of therapeutic options are common problems in managing these patients. In children vertical transmission of the virus leads to a high rate of chronic disease. As therapeutic options are not very promising prevention of infection is a major tool. Active immunization is a safe and successful way to decrease the infection rate amongst populations. The prevalence of HCV infection in children is often underestimated. Children who have been treated with blood or blood products before 1991 are at major risk for Hepatitis C infection. As HCV in children is often mostly present without any symptoms or with minor symptoms, the disease often remains undiagnosed for a long period of time, especially these patients are at risk to distribute the disease. HCV infection in children seems to be more benign compared to adults, the rate of spontaneous elimination of the virus seems to be higher in children. Treatment of HCV infection in children should currently performed within clinical trials only.