Published online Jan 21, 2022. doi: 10.3748/wjg.v28.i3.290
Peer-review started: June 3, 2021
First decision: July 27, 2021
Revised: August 12, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: January 21, 2022
Viral hepatitis infections are a great burden in children who have received liver transplant. Hepatotropic viruses can cause liver inflammation that can develop into liver graft fibrosis and cirrhosis over the long term. Immunological reactions due to viral hepatitis infections are associated with or can mimic graft rejection, rendering the condition difficult to manage. Prevention strategies using vaccinations are agreeable to patients, safe, cost-effective and practical. Hence, strategies to eliminate viral hepatitis A and B focus mainly on immunization programmes for children who have received a liver transplant. Although a vaccine has been developed to prevent hepatitis C and E viruses, its use is not licensed worldwide. Consequently, eliminating hepatitis C and E viruses mainly involves early detection in children with suspected cases and effective treatment with antiviral therapy. Good hygiene and sanitation are also important to prevent hepatitis A and E infections. Donor blood products and liver grafts should be screened for hepatitis B, C and E in children who are undergoing liver transplantation. Future research on early detection of viral hepatitis infections should include molecular techniques for detecting hepatitis B and E. Moreover, novel antiviral drugs for eradicating viral hepatitis that are highly effective and safe are needed for children who have undergone liver transplantation.
Core Tip: Viral hepatitis infections are a great burden for pediatric liver transplant recipients. Strategies to prevent infection include immunization, good sanitation and screening donor blood products and liver grafts for hepatitis B, C and E. In children infected with viral hepatitis who have received a liver transplant, early detection is crucial to guide proper management, as the infection can mimic or cause graft rejection. Effective antiviral therapy should be initiated when treating children with hepatitis B and C. Patients infected with hepatitis B who have undergone successful viral eradication should be revaccinated to maintain high hepatitis B surface antibodies to guarantee immunoprotection.