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Hepatitis C in childhood.

Winita Hardikar1

  • 1Paediatric Gastroenterology and Hepatology, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia. hardikaw@cryptic.rch.unimelb.edu.au

Journal of Gastroenterology and Hepatology
|May 2, 2002
PubMed
Summary

Pediatric management of hepatitis C virus (HCV) differs due to long-term uncertainty. Current treatment focuses on children with significant liver fibrosis and inflammation.

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Area of Science:

  • Pediatric Hepatology
  • Virology
  • Public Health

Background:

  • Hepatitis C virus (HCV) management in children presents unique challenges compared to adults, involving a chronic illness with uncertain long-term outcomes.
  • Prevalence of chronic HCV in children is low but varies regionally, with perinatal transmission being the primary route in most countries.
  • Post-transfusion HCV risk is minimized in many regions due to blood product screening.

Purpose of the Study:

  • To outline the distinct approach required for managing pediatric hepatitis C virus (HCV) infection.
  • To discuss the current understanding of HCV natural history, transmission, and treatment considerations in children.
  • To highlight the factors influencing treatment decisions and prevention strategies for pediatric HCV.

Main Methods:

  • Review of current literature on pediatric HCV management.
  • Analysis of transmission routes, including perinatal and blood-borne.
  • Evaluation of histological findings and long-term prognosis in pediatric cases.

Main Results:

  • Most children with HCV show mild histological changes; cirrhosis is rare.
  • Perinatal transmission is the predominant source, with a transmission risk of approximately 6%.
  • Antiviral treatment decisions are complex due to unclear long-term outcomes, with current recommendations targeting significant fibrosis.

Conclusions:

  • Pediatric HCV management requires a long-term perspective, differing significantly from adult practice.
  • Treatment should be reserved for children with significant hepatic fibrosis and necroinflammatory changes.
  • Prevention strategies, such as exploring the role of cesarean sections, are under investigation, while breastfeeding is not considered a risk.

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