Question
The baby is three and a half months old. She was hospitalized in the neonatal department for a week after birth due to jaundice. The diagnosis was mainly cholestasis, with other tests such as bacteria, viruses, endocrine, and hemolysis all negative. After treatment, she improved and was discharged, but the conjunctiva and skin still showed jaundice. At two months, the jaundice became more obvious, and she was hospitalized again. The test results showed a positive cytomegalovirus, with a urine cytomegalovirus DNA value of 4800. No abnormalities were found in genetic metabolism or other checks. After two weeks of treatment with ganciclovir antiviral and atorvastatin liver protection, the liver function alanine aminotransferase level was 113, and the aspartate aminotransferase level was 92. After discharge, she continued to take Tianqing tablet and ursodeoxycholic acid for liver protection treatment. Twenty days later, the urine cytomegalovirus DNA value dropped to 523, but the alanine aminotransferase level increased to 140, and the aspartate aminotransferase level remained at 91. Should another course of antiviral treatment be initiated, and are there better liver-protecting drug options?
Answer
For infant cytomegalovirus infection, there are currently no drugs used for treating hepatitis B virus infections. Treatment mainly focuses on liver protection and enzyme reduction. It is necessary to understand the amount of virus to determine the treatment plan. Generally, children under 6 years old do not undergo antiviral treatment, and those under 12 years old do not use oral antiviral medications. Interferon injections can be administered when necessary. It is recommended to complete HBV-DNA testing and provide liver protection and immune enhancement treatments.