With about 11 million children suffering from chronic hepatitis C infection worldwide, hepatitis C remains a major concern in pediatrics. In children, the main source of transmission is vertical, from the mother to the child around birth. Overall, 80% of infected children will develop a chronic infection, with about 1-2% evolving into hepatic cirrhosis. Pediatric treatments aim to eradicate the virus in order to reduce the transmission risk and prevent tissue damage in the long-term. Classical treatments based on pegylated interferon and ribavirin allow sustained virologic response to be achieved in about 45 to 95% of cases (1). In adults, new direct-acting antiviral (DAA) regimens have been approved in recent years and are now being used in the first-line setting. The first successful study that tested their efficacy in a pediatric population reported a sustained virological response in 97 to 100% of cases (2). If this rate is confirmed in other ongoing studies, disease eradication in the pediatric population should be feasible, enabling us to eradicate the virus reservoir, a latent source of new contaminations and chronic liver diseases.
What is already known about the topic?
- The goal of pediatric treatment is to eradicate the virus in a sustainable manner.
- Conventional treatments based on pegylated interferon and ribavirin are associated with significant side effects, in addition to providing only a suboptimal response.
- New therapies with direct antiviral agents have recently been approved and are recommended in adults
What does this article bring up for us?
This article discusses current therapies and the value of new direct antiviral agents in the management of chronic hepatitis C in children.
Key words
Hepatitis C, pediatrics, treatment, direct-acting antiviral