Huang L, Huang J. Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet. World J Gastroenterol 2026; 32(16): 117236 [DOI: 10.3748/wjg.v32.i16.117236]
Corresponding Author of This Article
Jialing Huang, MD, PhD, Associate Professor, Department of Pathology, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, 100 N Academy Avenue, Danville, PA 17822, United States. jhuang1@geisinger.edu
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Pediatrics
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Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 28, 2026 (publication date) through Apr 17, 2026
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Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Huang L, Huang J. Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet. World J Gastroenterol 2026; 32(16): 117236 [DOI: 10.3748/wjg.v32.i16.117236]
World J Gastroenterol. Apr 28, 2026; 32(16): 117236 Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.117236
Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet
Larry Huang, Jialing Huang
Larry Huang, University of Pennsylvania, Philadelphia, PA 19104, United States
Jialing Huang, Department of Pathology, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, Danville, PA 17822, United States
Co-first authors: Larry Huang and Jialing Huang.
Author contributions: Huang J collected data and revised the manuscript; Huang L collected and analyzed the data and wrote the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Jialing Huang, MD, PhD, Associate Professor, Department of Pathology, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, 100 N Academy Avenue, Danville, PA 17822, United States. jhuang1@geisinger.edu
Received: December 2, 2025 Revised: December 31, 2025 Accepted: February 25, 2026 Published online: April 28, 2026 Processing time: 136 Days and 10.6 Hours
Abstract
Hepatitis B virus-related cirrhosis in pediatric patients represents a silent yet rapidly progressive condition. Recent evidence from a study by Zhao et al published in the World Journal of Gastroenterology, highlights distinct clinical and pathological features of this pediatric disease compared to adult cirrhosis and demonstrates remarkable potential for reversal under timely antiviral therapy. This editorial explores the implications of these findings for clinical practice, policy, and research, emphasizing early detection, pediatric-specific management, and future directions to optimize clinical outcomes.
Core Tip: This editorial emphasizes that pediatric hepatitis B virus-related cirrhosis is a silent yet rapidly progressive condition that is often overlooked, despite its potential reversibility with timely antiviral therapy. Unlike adult cirrhosis, pediatric cases frequently present without symptoms, making early detection through routine screening essential. The manuscript highlights the unique pathophysiology in children: Marked high viral replication, minimal inflammation, and strong regenerative capacity, which creates a critical therapeutic window for fibrosis regression and functional cure. We recommend structured pediatric programs emphasizing periodic virologic and biochemical testing, a low threshold for elastography and other noninvasive fibrosis tools, prompt initiation of antiviral therapy in high-risk children, and sustained adherence support. These measures, coupled with reinforced perinatal prevention, can materially improve long-term outcomes.
