Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet

Core Tip

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.