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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
The natural history of hepatitis C virus infection acquired during childhood
Joan L Robinson1, Karen Doucette
1Department of Pediatrics, University of Alberta, Edmonton, Canada. jr3@ualberta.ca
Insights
Most children with hepatitis C virus (HCV) infection experience slow disease progression without antiviral therapy. This suggests no immediate need for treatment in the majority of pediatric cases.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Virology
Background:
- The long-term prognosis for children with hepatitis C virus (HCV) infection who do not receive antiviral treatment remains uncertain.
- Understanding childhood HCV outcomes is crucial for guiding clinical management and treatment decisions.
Purpose of the Study:
- To systematically review the outcomes of untreated hepatitis C virus (HCV) infection acquired during childhood.
- To focus on population-based studies to avoid bias from more severely affected referred cases.
Main Methods:
- A comprehensive literature search was conducted up to October 2010 for population-based studies screening for childhood HCV.
- Data on demographics, clinical information, and severe adverse outcomes (cirrhosis, hepatoma, transplant, liver death) were collected for untreated patients.
- The primary outcome assessed was the development of severe liver disease.
Main Results:
- The review included 25 studies with 733 children infected with HCV.
- Cirrhosis was diagnosed in 8 patients (1% of total, 4% of those biopsied).
- No other severe adverse outcomes were reported, precluding identification of risk factors for disease progression.
Conclusions:
- The majority of childhood hepatitis C virus (HCV) infections exhibit slow progression, with severe outcomes like liver transplant or death being rare.
- Current evidence does not support routine antiviral therapy for most children diagnosed with HCV infection.
Background:
The outcome of patients with hepatitis C virus (HCV) infection acquired during childhood in the absence of antiviral therapy is not clear.
Aims:
The purpose of this study was to review the outcome of untreated HCV acquired in childhood. Only population-based studies were included, as referred cases would be predicted to have more severe disease.
Methods:
A systematic review of the literature was completed up to October 2010 to identify studies where a population was screened for HCV infection that was presumably acquired during childhood. Demographical and clinical data were collected on infected patients who had not been treated with an antiviral. Primary outcome was development of a severe adverse outcome (cirrhosis, hepatoma, need for a liver transplant or liver-related death).
Results:
There were 25 studies reporting a total of 733 infected patients. Liver biopsy results were provided for 180 patients (25%), revealing cirrhosis in eight (1.0% of the total and 4.0% of those who had a biopsy). None of the other patients developed a severe adverse outcome. As a result of the small number of patients with a severe adverse outcome, risk factors for HCV progression could not be identified.
Conclusion:
Although HCV can lead to liver transplantation and death during childhood, the vast majority of patients with disease acquired during childhood have slowly progressive disease. There is no clear indication for antiviral therapy in the majority of children with HCV infection.
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