Publication Name	World Journal of Gastroenterology
Manuscript ID	117236
Country	United States

Category	Pediatrics
Manuscript Type	Editorial
Article Title	Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet
Manuscript Source	Invited Manuscript
All Author List	Larry Huang and Jialing Huang
Funding Agency and Grant Number
Corresponding Author	Jialing Huang, Associate Professor, MD, PhD, Department of Pathology, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, 100 N Academy Avenue, Danville, PA 17822, United States. jhuang1@geisinger.edu
Key Words	Pediatric; Hepatitis B virus; Liver cirrhosis; Antiviral therapy; Prognosis; Fibrosis regression
Core Tip	This editorial emphasizes that pediatric HBV-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.
Citation	Huang L, Huang J. Silent progression and therapeutic reversibility of pediatric hepatitis B virus-related cirrhosis: Needs unmet. World J Gastroenterol 2026; In press

Received	2025-12-02 00:54
Peer-Review Started	2025-12-02 00:54
First Decision by Editorial Office Director	2025-12-17 10:11
Return for Revision	2025-12-17 10:11
Revised	2025-12-31 01:31
Publication Fee Transferred
Second Decision by Editor	2026-02-25 02:38
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-25 08:33
Articles in Press	2026-02-25 08:33
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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