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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
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Hepatitis C: Issues in Children

Christine K Lee1, Maureen M Jonas1

  • 1Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.

Gastroenterology Clinics of North America
|November 25, 2015
PubMed

Insights

Most children with Hepatitis C virus (HCV) infection go undiagnosed, with perinatal transmission being the primary cause. Pediatric HCV treatment should prioritize newer direct-acting antivirals, deferring current options if possible.

Area of Science:

  • Hepatology
  • Pediatric Infectious Diseases
  • Virology

Background:

  • Hepatitis C infection presents a significant global health challenge, particularly in pediatric populations where diagnosis rates are low.
  • Perinatal transmission is the predominant route for Hepatitis C virus (HCV) acquisition in children.
  • Chronic HCV infection in children typically progresses slowly with rare severe complications during childhood.

Purpose of the Study:

  • To review the current landscape of Hepatitis C virus (HCV) infection in children.
  • To discuss the evolving treatment strategies for pediatric HCV.
  • To provide guidance on managing HCV in pediatric patients, considering recent advancements in adult treatment.

Main Methods:

  • Literature review of pediatric HCV epidemiology and treatment.
  • Analysis of current and emerging antiviral therapies for HCV.
  • Evaluation of treatment guidelines for children based on adult data and pediatric-specific considerations.

Main Results:

  • The majority of infected children remain undiagnosed, highlighting a critical gap in identification and care.
  • Current treatment recommendations for pediatric HCV emphasize deferring therapy until direct-acting antivirals (DAAs) and interferon-free regimens are approved for this age group.
  • Peginterferon and ribavirin remain an option for children with compensated liver disease if treatment cannot be postponed.

Conclusions:

  • Early identification of perinatal HCV infection in children is crucial for timely management.
  • The advent of DAAs and interferon-free regimens offers promising, more effective treatment options for pediatric HCV.
  • Management strategies must balance the need for treatment with the availability of age-appropriate, safe, and effective therapies for children.

Keywords:
ChildrenDirect acting antiviralHepatitis CPegylated interferonPerinatal transmissionRibavirin

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