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Unique Challenges of Hepatitis C in Infants, Children, and Adolescents
Claudia Espinosa1, Ravi Jhaveri2, A Sidney Barritt3
1Division of Pediatric Infectious Disease, University of Louisville School of Medicine, Louisville, Kentucky.
Insights
Hepatitis C now significantly impacts young people, including children and adolescents, due to the opioid epidemic. Lack of universal screening and treatment perpetuates this deadly chronic disease, which is unacceptable with modern therapies.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Hepatitis C is a serious chronic disease with severe health consequences.
- The demographic of Hepatitis C infection is shifting, with younger populations increasingly affected.
Purpose of the Study:
- To examine the impact of Hepatitis C on infants via vertical transmission.
- To assess the effects of Hepatitis C infection in children and adolescents.
Main Methods:
- A focused literature review was performed on vertical transmission and pediatric/adolescent infections.
- Author expertise and first-hand experience supplemented the literature findings.
Main Results:
- Young individuals, including women of childbearing age, infants, children, and adolescents, are disproportionately affected.
- Intravenous drug use and the opioid epidemic are primary drivers of new Hepatitis C infections in youth.
- Current disease estimates are inaccurate due to the absence of universal screening in at-risk populations.
Conclusions:
- Failure to implement widespread screening and treatment policies will lead to the continued spread of Hepatitis C.
- The persistence of Hepatitis C in young people is unacceptable given the availability of highly effective, FDA-approved therapies for children.
Purpose:
Hepatitis C, a chronic disease with deadly consequences, is no longer predominantly a disease of older people.
Methods:
A limited search was conducted of the relevant literature on 2 topics: (1) the impact of hepatitis C on infants exposed by vertical transmission; and (2) the impact of hepatitis C infection on infected children and adolescents. The findings were supplemented by the first-hand experience of the authors.
Findings:
Young people, including women of childbearing age, infants, children, and adolescents, are being especially affected by hepatitis C infection secondary to the intravenous drug use and opioid epidemic. Unfortunately, estimates of disease in young populations are all misleading because universal screening has not been implemented.
Implications:
Lack of implementation of policies for screening and therapy on most affected populations will be responsible for perpetuation of this infection. In the era of highly effective therapy and a regimen that is approved by the US Food and Drug Administration for children, this outcome is unacceptable.
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