Natural history of vertically acquired HCV infection and associated autoimmune phenomena

Garazzino, Silvia; Calitri, Carmelina; Versace, Antonio Giovanni; Alfarano, A; Scolfaro, Carlo; Bertaina, Chiara; Vatrano, Simona; Mignone, F; Licciardi, Francesco; Gabiano, Clara; Tovo, Pier-Angelo

doi:10.1007/s00431-014-2286-6

Cited by 53 publications

(51 citation statements)

References 34 publications

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“…Another 6%‐12% of those with chronic hepatitis C infection may clear the virus before adulthood 4, 39, 64, 65, 66. Spontaneous viral clearance, which is associated with biochemical remission of hepatitis, has been reported to occur more frequently in children with higher alanine aminotransferase levels in the first 2 years of life 30, 38, 66, 67, 68, 69, 70. Both host and viral factors have been associated with the attainment of spontaneous viral clearance; these include infection with genotype 3 and the interleukin 28B rs12979860 single‐nucleotide polymorphism 38, 67, 71, 72.…”

Section: Natural History Of Hcv Infection In Children and Adolescentsmentioning

confidence: 99%

“…Spontaneous viral clearance, which is associated with biochemical remission of hepatitis, has been reported to occur more frequently in children with higher alanine aminotransferase levels in the first 2 years of life 30, 38, 66, 67, 68, 69, 70. Both host and viral factors have been associated with the attainment of spontaneous viral clearance; these include infection with genotype 3 and the interleukin 28B rs12979860 single‐nucleotide polymorphism 38, 67, 71, 72. Spontaneous viral clearance has historically been considered a permanent state and an essential “cure” of the HCV infection in the child; however, a recent case report described recurrence of viremia following seroconversion and suggests that a more nuanced approach to the care of these children may be warranted 64…”

Section: Natural History Of Hcv Infection In Children and Adolescentsmentioning

confidence: 99%

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Hepatitis C virus infection in children and adolescents

Squires

Balistreri

2017

Hepatology Communications

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Section: Natural History Of Hcv Infection In Children and Adolescentsmentioning

confidence: 99%

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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“…The clinical course of CHC acquired in childhood appears to be mild: most children are asymptomatic, there is no effect on growth,14 histopathological changes usually only show minimal inflammation,15 and hepatocellular carcinoma is rare, with two cases having been documented 16. On the other hand, adolescents who become infected follow the adult pattern of disease 2.…”

Section: Natural History Of Hcv In Childrenmentioning

confidence: 99%

The Role of Direct-acting Antivirals in the Treatment of Children with Chronic Hepatitis C

Yang

Yoo

Ahmed

2017

JCTH

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In the United States, chronic infection with the hepatitis C virus (HCV) affects an estimated 0.1-2% of the pediatric population, who are consequently at risk for major complications, including cirrhosis, hepatocellular carcinoma, and death. The current standard of treatment for chronic hepatitis C (CHC) in children is pegylated-interferon-alpha (PEG-IFN) in combination with ribavirin. PEG-IFN/ribavirin therapy is approved for children ages 3 and older; however, it is often held from use until adulthood because of its extensive list of potential side effects and high likelihood of causing adverse symptoms. While CHC is usually indolent in children and adolescents, immediately treating and curbing the spread of HCV before adulthood is important, as there can be transmission to other individuals via sexual activity and infected females can later vertically transmit the infection during pregnancy, the latter representing the most common means of transmission for children in the United States. The recent development of direct-acting antivirals has shown promising results in clinical trials for use in children and has dramatically increased the rates of sustained virological response in adults while improving side effect profiles as compared to interferonbased treatments. Given the usually indolent course of CHC in children, significant side effects of the currently-approved PEG-IFN/ribavirin therapy, and likely availability of all-oral interferon-free regimens for children within a few years, deferring treatment in clinically-stable children with CHC in anticipation of upcoming superior treatment modalities may be justified. Citation of this article: Yang CHT, Yoo ER, Ahmed A. The role of direct-acting antivirals in the treatment of children with chronic hepatitis C.

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“…Rather than deferring therapy until a particular age or waiting for evidence of significant liver disease, treatment could be given as soon as a diagnosis of chronic hepatitis C were made. That being said, in cases of vertical transmission there may be rationale to defer therapy until age 3 years due to the relatively prolonged capacity of infants and toddlers to spontaneously resolve infection [5, 13]. …”

Section: Prospects For Bringing Daas To Childrenmentioning

confidence: 99%

“…Vertical transmission, injection drug use (IDU), and iatrogenic exposures account for most pediatric infections. While some of these infections resolve spontaneously, approximately 60–80% of vertically- and horizontally-acquired pediatric HCV infections persist indefinitely [3–5]. Persistent hepatitis C infections predispose to complications including hepatic fibrosis, cirrhosis, and hepatocellular carcinoma.…”

Section: Introductionmentioning

confidence: 99%

New prospects for the treatment and prevention of hepatitis C in children

Ohmer¹,

Honegger

2016

Current Opinion in Pediatrics

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Purpose of review Combined pegylated interferon-α and ribavirin remain the standard therapy for pediatric hepatitis C virus (HCV) infection in 2016, but direct acting antivirals (DAAs) with greatly improved efficacy and safety are now approved for adults. Here we review the major classes of DAAs and their anticipated use for treatment and potentially prevention of HCV in children. Recent findings Currently approved DAAs target the viral protease, polymerase, and NS5A, a protein involved in viral replication and assembly. In combination, they have lifted sustained virologic response rates to over 90% for multiple HCV genotypes, and the rich DAA pipeline promises further improvements. Clinical trials of interferon-free DAA regimens have been initiated for children ages 3–17 years. The first efficacy trial of a preventative HCV vaccine for adults is also underway. While awaiting a vaccine, there is hope that increased DAA uptake may prevent pediatric HCV infections by shrinking the pool of infectious persons. Summary Interferon-free DAA regimens have revolutionized therapy for HCV-infected adults and pending results of pediatric trials will likely do the same for HCV-infected children. If widely deployed, particularly amongst individuals likely to transmit HCV, DAA therapies may also help reduce new vertically- and horizontally-acquired pediatric infections.

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Natural history of vertically acquired HCV infection and associated autoimmune phenomena

Cited by 53 publications

References 34 publications

Hepatitis C virus infection in children and adolescents

Hepatitis C virus infection in children and adolescents

The Role of Direct-acting Antivirals in the Treatment of Children with Chronic Hepatitis C

New prospects for the treatment and prevention of hepatitis C in children

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