Hepatocellular Carcinoma in 2 Young Adolescents With Chronic Hepatitis C

González‐Peralta, Regino P.; Langham, Max R.; Andres, Joel M.; Mohan, Parvathi; Colombani, Paul M.; Alford, Mary Kay; Schwarz, Kathleen B.

doi:10.1097/mpg.0b013e318170af04

Cited by 117 publications

(102 citation statements)

References 31 publications

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“…169,170 Hepatocellular carcinoma due to HCV infection is extremely uncommon in childhood; only a few cases have been reported to date. 171 Extrahepatic disorders due to HCV, particularly membrano-proliferative glomerulonephritis, may occur in children although neither cryoglobulinemia nor lymphoma has yet been reported. Children with chronic hepatitis C (CHC) should be followed annually with a physical examination and blood tests for evidence of liver injury and ongoing viremia.…”

Section: Hepatitis C In Childrenmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Hepatitis C In Childrenmentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…The natural history of hepatitis C in children is very different from that seen in adults, and although the progression of chronic hepatitis to cirrhosis is unlikely, it may even progress to hepatocellular carcinoma [13] . Since viral screening began to be used routinely in blood donors, vertical transmission became the main cause of hepatitis C in children.…”

Section: Viral Hepatitismentioning

confidence: 99%

Cirrhosis in children and adolescents: An overview

Pinto

Schneider

Silveira

2015

WJH

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Several conditions, especially chronic liver diseases, can lead to cirrhosis in children and adolescents. Most cases in clinical practice are caused by similar etiologies. In infants, cirrhosis is most often caused by biliary atresia and genetic-metabolic diseases, while in older children, it tends to result from autoimmune hepatitis, Wilson's disease, alpha-1-antitrypsin deficiency and primary sclerosing cholangitis. The symptoms of cirrhosis in children and adolescents are similar to those of adults. However, in pediatric patients, the first sign of cirrhosis is often poor weight gain. The complications of pediatric cirrhosis are similar to those observed in adult patients, and include gastrointestinal bleeding caused by gastroesophageal varices, ascites and spontaneous bacterial peritonitis. In pediatric patients, special attention should be paid to the nutritional alterations caused by cirrhosis, since children and adolescents have higher nutritional requirements for growth and development. Children and adolescents with chronic cholestasis are at risk for several nutritional deficiencies. Malnutrition can have severe consequences for both pre-and post-liver transplant patients. The treatment of cirrhosis-induced portal hypertension in children and adolescents is mostly based on methods developed for adults. The present article will review the diagnostic and differential diagnostic aspects of end-stage liver disease in children, as well as the major treatment options for this condition.

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“…Complications from chronic HCV‐related liver disease in children and adolescents, such as portal hypertension, ascites, variceal bleeding, and hepatocellular carcinoma, although uncommon, have been reported 2, 73, 89, 90, 91. Decompensated cirrhosis in children as young as 4 years of age has been described 48, 78, 91, 92.…”

Section: Natural History Of Hcv Infection In Children and Adolescentsmentioning

confidence: 99%