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Vertical genotype 1 HCV infection treated successfully in the second year of life: a case report
Małgorzata Pawłowska1, Waldemar Halota, Ewa Smukalska
1Chair of Infectious Diseases and Hepatology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland. mpawlowska@cm.umk.pl
Insights
This study shows successful treatment of Hepatitis C virus (HCV) in a one-year-old child using interferon-alpha2b and ribavirin. The child achieved a sustained virological response for six years with no significant adverse events.
Area of Science:
- Hepatology
- Pediatric Infectious Diseases
- Virology
Background:
- Perinatal Hepatitis C virus (HCV) transmission is a significant cause of HCV infection in children.
- Treatment for chronic hepatitis C in young children remains controversial due to potential spontaneous clearance and adverse events.
Observation:
- A 3-month-old infant was diagnosed with vertical Hepatitis C virus (HCV) genotype 1 infection.
- Clinical findings included hepatomegaly and fluctuating liver enzyme levels (ALT, AST, GGT).
- HCV RNA levels were significantly elevated (>700,000 IU/ml) at diagnosis.
Findings:
- A one-year-old was treated with interferon-alpha2b and ribavirin for 48 weeks.
- Hepatitis C virus (HCV) RNA undetectable by week 12, leading to sustained virological response (SVR).
- Sustained virological response (SVR) was maintained for six years post-treatment without significant adverse events.
Implications:
- This case demonstrates the feasibility of successful anti-HCV therapy in a young pediatric patient.
- The findings support the potential efficacy of combined interferon-alpha2b and ribavirin for treating early childhood Hepatitis C virus (HCV) infection.
- Long-term follow-up confirmed the safety and sustained effectiveness of this treatment regimen.
Background:
Perinatal HCV transmission appears to be an important cause of HCV in children. Treatment of chronic hepatitis C in young children is controversial because of spontaneous HCV clearance and possible adverse events.
Case Report:
Vertical HCV genotype 1 infection was diagnosed in a 3-month-old infant. In the subsequent clinical examination we still observed hepatomegaly, fluctuations of ALT, AST and GGT activity, with the highest values 2206 U/L, 1319 U/L, and 297 U/L, respectively. In qPCR, HCV RNA was >700.000 IU/ml. In the 42nd week of observation, liver biopsy was performed with Grade 1 grading and Grade 1 staging. At age 12 months, interferon-alpha2b (1.5 MU 3 times a week) and ribavirin (2×80 mg daily) were administered for 48 weeks. At the beginning of the treatment we observed fever after IFN injection. In the 12th week of therapy, HCV RNA disappeared followed by SVR, and it was sustained for 6 years. To our knowledge, this is the first report of a pediatric (1-year-old) patient treated with combined IFN alpha-2b and ribavirin therapy.
Conclusions:
This case report confirms the possibility of successful anti-HCV treatment in a young child, with 6-year sustained virological response without significant adverse events.
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