Chronic Hepatitis C Virus Infection in Children

Abstract

The importance of hepatitis C viral infection in the health care of children has grown in recent decades. More is now known about the epidemiology of this infection in children and the progression of disease in the pediatric age group, and the treatment options are increasing. In this review, we update readers on the state of our understanding of hepatitis C infection in children, provide the current recommendations for monitoring and treatment, and discuss emerging therapies.

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

“…Some experts prefer starting treatment earlier as there is better treatment response and tolerability of PEG‐IFN and ribavirin in children compared with adults 144, 145. This may be especially relevant for patients with HCV genotypes 2 and 3, for whom sustained virological response with PEG‐IFN and ribavirin over 24 weeks is much better than for genotype 1 (sustained virological response in HCV‐monoinfected children 89–93% 146, 147.…”

Hepatitis C virus infection in children and adolescents

“…This pattern has been validated in multiple studies 4, 42, 46, 73, 74, 75, 76. One study included up to 35 years of follow‐up and established that HCV infection acquired in early life typically shows a slow progression and mild course and outcome in the absence of other risk factors, such as obesity 77…”

“…More commonly, children and adolescents develop chronic hepatitis C infection, defined as the persistence of HCV RNA for at least 6 months 45, 46. The typical pattern of virologic, clinical, and serological events in children with perinatal infection is demonstrated in Fig.…”

“…The majority of HCV‐infected children will have intermittent or persistent liver enzyme elevations. Importantly, aminotransferase levels do not correlate with histological severity 46. Accordingly, a liver biopsy is not necessary for most pediatric patients with HCV.…”

Personalized Approach to Treating Chronic Hepatitis C in Children

“…Efficacy of interferon therapy for chronic hepatitis (Hepatitis C Virus, HCV) in children varies from 0.0 to 90.0% depending on the applied treatment regimens and HCV genotype [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Fast virological response and early virological response are predictors of favorable interferon therapy outcome in adults -sustained virological remission (SVR) is achieved in 89 and 70% of cases, respectively [15].…”