Treatment of Chronic Hepatitis C in Young Children Reduces Adverse Outcomes and Is Cost-Effective Compared with Deferring Treatment to Adulthood

Greenaway, Emma; Haines, Alex; Ling, Simon C.; Krahn, Murray

doi:10.1016/j.jpeds.2020.08.088

Cited by 18 publications

(15 citation statements)

References 26 publications

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“…Nguyen et al [ 81 ] found that early DAA treatment in adolescent patients with chronic HCV infection was cost-effective compared with deferred treatment, with approximately $27000 per QALY gained after 30 years. Greenaway et al [ 82 ] published data comparing treatment at age 6 years vs delaying treatment until age 18 years. In their model covering 20 years and treating 10000 children early, 330 cases of cirrhosis, 18 cases of hepatocellular carcinoma, and 48 liver-related deaths would be avoided.…”

Section: Where Do We Stand?mentioning

confidence: 99%

Cascade of care for children and adolescents with chronic hepatitis C

Rogers¹,

Balistreri²

2021

WJG

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Chronic hepatitis C virus (HCV) infection presents a significant global public health burden. In 2015, over 400000 deaths worldwide were attributed to HCV infection. This led the World Health Organization (WHO) in 2016 to set the ambitious goal of eliminating HCV by 2030. Adult-centered guidelines have been established in order to provide direction for healthcare professionals, allowing integration of the newest screening policies and therapeutic strategies into their practices. However, for children and adolescents, HCV is a significant, unrecognized public health problem. HCV infection rates in the United States in women of childbearing age and those who are pregnant have increased in parallel with the rising opioid epidemic. An estimated 29000 women with HCV infection gave birth each year from 2011 to 2014 in the United States, with approximately 1700 of their infants being infected with HCV. Newer HCV-specific therapeutics, namely direct acting antivirals (DAA), has brought a new and highly successful approach to treatment of hepatitis C. Recent studies have confirmed similar levels of effectiveness and safety of DAA therapies in the pediatric population. Thus, an enhanced cascade of care, which should include the population under 18 years of age, can help achieve the WHO goal by focusing on elimination in the youngest populations. This review will present an overview of the natural history, clinical features, and management of HCV in children and adolescents.

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Section: Where Do We Stand?mentioning

confidence: 99%

Cascade of care for children and adolescents with chronic hepatitis C

Rogers¹,

Balistreri²

2021

WJG

View full text Add to dashboard Cite

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“…Recientemente se demostró que el tratamiento de la infección con el VCH en niños pequeños es costo efectivo, al compararlo con su indicación en la edad adulta. 27,28 La Food and Drug Administration (FDA), agencia del Gobierno de los Estados Unidos responsable de la regulación de medicamentos y alimentos, y la Agencia Europea de Medicamentos (EMA) aprobaron, en pacientes de 12 a 18 años (o en aquellos que superaran los 35 kg de peso), una dosis fija de ledipasvir/sofosbuvir para la infección con genotipos 1 y 4-6 o la combinación de sofosbuvir y ribavirina para los genotipos 2 o 3.…”

Section: Tratamientos De La Infección Crónica Por Virus C De La Hepatunclassified

Hepatitis C: ¿un virus que podríamos erradicar?

2021

Arch Argent Pediat

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La infección crónica con el virus C de la hepatitis constituye un problema de salud a nivel mundial, tanto en niños como en adultos. Su eliminación espontánea puede ocurrir durante la infancia temprana, y luego es infrecuente. Aunque la mayoría de los casos son asintomáticos en la infancia y adolescencia, al llegar a la edad adulta, los pacientes pueden evolucionar a la cirrosis y presentar complicaciones, que incluyen el carcinoma hepatocelular. Un tratamiento eficaz debe tener como meta la eliminación del virus, lo que significaría la curación de la enfermedad. Recientemente, el advenimiento de varios agentes antivirales de acción directa ha posibilitado una alta resolución de la infección, del 97-100 % de los casos. Para lograr este objetivo costo-efectivo, es fundamental la concientización de los pediatras en la detección de los pacientes infectados y su derivación al especialista hepatólogo pediatra para la implementación del tratamiento adecuado.

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“…Recently, it has been demonstrated that HCV treatment in young children is cost-effective compared to its indication in adults. 27,28 T h e U n i t e d S t a t e s F o o d a n d D r u g Administration (FDA), a government agency responsible for regulating foods and drugs, and the European Medicines Agency (EMA) approved, for patients aged 12-18 years (or for those who with a weight of 35 kg or more), a fixed ledipasvir/sofosbuvir dose for those infected with genotypes 1 and 4-6 or the sofosbuvir and ribavirin combination for those with genotypes 2 or 3.…”

Section: Treatments For Chronic Hepatitis C Virus Infectionmentioning

confidence: 99%

Hepatitis C: Could we eradicate this virus?

2021

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Chronic hepatitis C virus infection is a health problem worldwide, both in children and adults. Its spontaneous resolution may occur during early childhood, and then it becomes uncommon. Although most cases are asymptomatic during childhood and adolescence, as adults, patients may progress to cirrhosis and develop complications, including hepatocellular carcinoma. The goal of an effective treatment should be virus elimination, i.e., disease cure. Recently, the emergence of several direct-acting antivirals has enabled a high rate of infection resolution in 97-100 % of cases. To achieve this cost-effective objective, it is critical to raise awareness among pediatricians so that they can detect infected patients and refer them to a pediatric liver specialist for an adequate management.

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Treatment of Chronic Hepatitis C in Young Children Reduces Adverse Outcomes and Is Cost-Effective Compared with Deferring Treatment to Adulthood

Cited by 18 publications

References 26 publications

Cascade of care for children and adolescents with chronic hepatitis C

Cascade of care for children and adolescents with chronic hepatitis C

Hepatitis C: ¿un virus que podríamos erradicar?

Hepatitis C: Could we eradicate this virus?

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