Low viraemia at enrollment in children with chronic hepatitis C favours spontaneous viral clearance

Chen, S.-T.; Ni, Yen‐Hsuan; Chen, P.-J.; Chen, H.-L.; Jeng, Yung‐Ming; Lu, M-Y; Wu, Jia‐Feng; Hsu, Hong‐Yuan; Chang, Mei–Hwei

doi:10.1111/j.1365-2893.2009.01135.x

Cited by 13 publications

(7 citation statements)

References 32 publications

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“…31 There are also several other smaller prospective 32,33 and retrospective cohorts and case studies. [34][35][36][37][38][39][40][41][42][43][44] Following vertical acquisition, between 25 and 40% of infected children spontaneously clear the infection in the first four years of life, 5,6,33 which is slightly higher than rates reported in adults.…”

Section: Routes Of Transmissionmentioning

confidence: 99%

Hepatitis C virus infection in children and adolescents

Indolfi

Easterbrook

Dusheiko

et al. 2019

The Lancet Gastroenterology & Hepatology

151

147

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Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and associated morbidity and mortality worldwide. Short-course, oral, curative, direct-acting antiviral regimens have now transformed treatment for HCV infection. Since the launch in 2016 of the first global strategy towards elimination of viral hepatitis as a public health threat by 2030, the predominant focus of the global response has been on treatment of adults, who bear the greatest burden of morbidity and mortality of HCV related chronic liver disease. There has been much less attention paid to addressing response to HCV in children and adolescents, in part because of the lack of data to inform specific paediatric management practices and policy. In this review, we summarize current knowledge on epidemiology, natural history, and treatment of chronic HCV infection in adolescents and children, and highlight key differences from infection acquired in adulthood. The estimated global prevalence and burden in children aged 1 to 19 years is 0•15% and 3•5 (3•1-3•9) million, respectively. HCV infection is usually asymptomatic during childhood, and cirrhosis and hepatocellular carcinoma are rare. Sofosbuvir, ledipasvir and ribavirin have now received regulatory approval and guidelines recommend their use in adolescents ages >12 years with HCV infection. Key actions to address the current policy gaps and achieve treatment scale-up comparable to that in adults include: establishment of a testing and treatment access campaign targeted at children and adolescents; fast-track evaluation of pangenotypic regimens and accelerated approval of paediatric formulations. Research gaps that need to be addressed include age-specific seroprevalence studies of HCV viraemia in priority countries; further validation of non-invasive tests in children; and establishment of paediatric treatment registries and international consortia to promote collaborative research agenda.

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Section: Routes Of Transmissionmentioning

confidence: 99%

Hepatitis C virus infection in children and adolescents

Indolfi

Easterbrook

Dusheiko

et al. 2019

The Lancet Gastroenterology & Hepatology

151

147

View full text Add to dashboard Cite

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“…(49) Chen et al reported a study of 42 children chronically infected with HCV, with an RNA level below 4.5 × 10(4) IU/mL at enrollment, having a higher rate of spontaneous viral clearance. (50)…”

Section: Hcvmentioning

confidence: 99%

Hepatitis B and C

Karnsakul

Schwarz

2017

Pediatric Clinics of North America

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Synopsis Provide a brief summary of your article (100 to 150 words; no references or figures/tables). The synopsis appears only in the table of contents and is often used by indexing services such as PubMed Chronic viral hepatitis continues to be a global health threat and a financial burden. Hepatitis B and C viruses (HBV and HCV) are the most common causes of chronic viral hepatitis in the United States. The majority of cases are asymptomatic during childhood and young adulthood. Cirrhosis and hepatocellular carcinoma are rare during childhood but commonly expected in adulthood. Efforts from worldwide health organizations, pharmaceutical industries, and clinical and research institutions have resulted in much new knowledge, very effective therapy for HCV-infected children and the promise of new effective therapies for HBV-infected children. For HCV-infected children the current standard of care is pegylated interferon and ribavirin but clinical trials with highly effective direct acting antiviral agents are currently underway in the pediatric age group. There are currently 5 FDA-approved agents for HBV-infected children: alpha-interferon, lamivudine, adefovir, tenofovir, and entecavir. However treatment with these agents seldom results in a functional cure and more effective therapies are urgently needed

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“…Whether a low viral load (<4.5×10 4 IU/ml) is associated with a higher probability of HCV clearance as suggested recently [6], cannot be addressed here, as all of the analyzed children had a viral load >4.5×10 4 IU/ml at least once. We suggest that although a lower viral load might be favourable, a high viral load does not exclude spontaneous viral clearance in vertically infected children.…”

Section: Discussionmentioning

confidence: 81%