Long-Term Course of Chronic Hepatitis C in Children: From Viral Clearance to End-Stage Liver Disease

Bortolotti, Flavia; Verucchi, Gabriella; Cammà, Calogero; Cabibbo, Giuseppe; Zancan, Lucia; Indolfi, Giuseppe; Giacchino, Raffaella; Marcellini, Matilde; Marazzi, Maria Grazia; Barbera, Cristiana; Maggiore, Giuseppe; Vajro, Pietro; Bartolacci, S.; Balli, Fiorella; Maccabruni, Anna; Guido, Maria

doi:10.1053/j.gastro.2008.02.082

Cited by 238 publications

(261 citation statements)

References 30 publications

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“…168 Natural history in children: About 7-25% of vertically infected infants clear their infection spontaneously, usually by 24 months of age. 169,170 Infection acquired during infancy progresses slowly over several decades with minimally deranged liver enzymes and minimal fibrosis, and only 5-20% develop cirrhosis after 20 years of infection. However, 2% develop cirrhosis in childhood and require liver transplantation.…”

Section: Hepatitis C In Childrenmentioning

confidence: 99%

“…However, 2% develop cirrhosis in childhood and require liver transplantation. 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.…”

Section: Hepatitis C In Childrenmentioning

confidence: 99%

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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%

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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“…In most centres this screening includes a combination of PCR for detection of HCV RNA in infancy as well as HCV antibody at 12–18 months when maternal antibody is expected to wane. HCV RNA‐positive results in infancy do not equate to long‐term infection, and follow‐up is required as a small proportion of HCV‐monoinfected children will undergo spontaneous clearance of infection within the first 3–5 years of life 136, 137. Published data are sparse on the rates of spontaneous HCV clearance in HIV coinfected children.…”

Section: Coinfectionsmentioning

confidence: 99%

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

et al. 2015

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The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained.

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“…This pattern has been validated in multiple studies 4, 42, 46, 73, 74, 75, 76. One study included up to 35 years of follow‐up and established that HCV infection acquired in early life typically shows a slow progression and mild course and outcome in the absence of other risk factors, such as obesity 77…”

Section: Natural History Of Hcv Infection In Children and Adolescentsmentioning

confidence: 82%

“…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%

Hepatitis C virus infection in children and adolescents

Squires

Balistreri

2017

Hepatology Communications

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Long-Term Course of Chronic Hepatitis C in Children: From Viral Clearance to End-Stage Liver Disease

Cited by 238 publications

References 30 publications

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

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

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

Hepatitis C virus infection in children and adolescents

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