For a 10-month-old with chronic hepatitis B infection, what is the recommended management?

• A. Provide supportive care
• B. Consider use of lamivudine
• C. Prescribe interferon-alfa
• D. Consult a pediatric infectious disease specialist

Answer: (D)

Chronic hepatitis B in infancy requires specialized input to determine if and when treatment is needed. A 10‑month‑old should be evaluated by a pediatric infectious disease (or hepatology) specialist who can assess liver inflammation, viral activity, and overall liver health to decide whether antiviral therapy is indicated and which regimen would be appropriate. In many cases of infant chronic HBV, careful monitoring is appropriate, but treatment decisions are nuanced and depend on ALT levels, HBV DNA, serology, and possibly imaging or biopsy findings. Therapies such as lamivudine or interferon alfa carry limited pediatric data, potential resistance, and higher risk of adverse effects in infants, so initiating these without specialist guidance is not ideal. Consulting a specialist ensures a tailored plan that addresses the child’s specific disease activity and safety.