Adolescent Hepatitis C: Prevalence, Impact, and Management Challenges.

Area of Science:

• Hepatology
• Infectious Diseases
• Adolescent Medicine

Background:

• Hepatitis C virus (HCV) infection prevalence is rising in the US, particularly among youth, linked to the opioid crisis and intravenous drug use (IVDU).
• Adolescent HCV infection's impact and prevalence are poorly understood, despite risks of liver disease progression, cirrhosis, and reduced quality of life.

Purpose of the Study:

• To review the current understanding of HCV in adolescents.
• To highlight the effectiveness of new direct-acting antiviral (DAA) therapies for pediatric HCV.
• To emphasize the need for increased screening and treatment in at-risk adolescent populations.

Main Methods:

• This review synthesizes current literature on HCV epidemiology, clinical presentation, and management in adolescents.
• It examines the impact of direct-acting antiviral (DAA) regimens on pediatric HCV treatment.
• It discusses barriers to testing and treatment and proposes strategies for improved healthcare access.

Main Results:

• Direct-acting antiviral (DAA) regimens are now approved for HCV in children over 3 years old, offering shorter, highly effective, and well-tolerated oral treatment.
• HCV treatment is indicated for all adolescents regardless of liver disease stage, IVDU status, or HIV coinfection.
• Despite effective treatments, adolescents are significantly underdiagnosed and undertreated for HCV.

Conclusions:

• Adolescent HCV infection requires urgent attention due to rising rates and potential long-term complications.
• Point-of-care (POC) testing in high-risk settings can improve diagnosis and linkage to care.
• Pediatricians and primary care providers need enhanced education to address the knowledge gap and improve HCV management in youth.