Hepatitis C virus infection in children and adolescents
Journal
The Lancet Gastroenterology and Hepatology
Journal Volume
4
Journal Issue
6
Pages
477-487
Date Issued
2019
Author(s)
Indolfi G.
Easterbrook P.
Dusheiko G.
El-Sayed M.H.
Jonas M.M.
Thorne C.
Bulterys M.
Siberry G.
Walsh N.
Meyers T.
Giaquinto C.
Wirth S.
Chan P.-L.
Penazzato M.
Abstract
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and associated morbidity and mortality worldwide. Short-course, oral, curative, direct-acting antiviral regimens have transformed treatment for HCV infection. Since the 2016 launch of the first global strategy towards elimination of viral hepatitis as a public health threat by 2030, the predominant focus of the global response has been on the treatment of adults, who bear the greatest burden of morbidity and mortality of HCV-related chronic liver disease. Compared with adults, there has been little attention paid to addressing the response to HCV in children and adolescents, in part because of the scarcity of data to inform specific paediatric management practices and policy. In this Series paper, we summarise knowledge on the epidemiology, natural history, and treatment of chronic HCV infection in adolescents and children, and we highlight key differences from infection acquired in adulthood. The estimated global prevalence and burden of HCV infection in children aged 1–19 years is 0·15%, corresponding to 3·5 million people (95% CI 3·1–3·9 million). HCV infection is usually asymptomatic during childhood, and cirrhosis and hepatocellular carcinoma are rare. Sofosbuvir with ledipasvir and sofosbuvir with ribavirin have received regulatory approval and guidelines recommend their use in adolescents aged 12 years and older with HCV infection. In April, 2019, glecaprevir with pibrentasvir also received regulatory approval for adolescents aged 12–17 years. Key actions to address the current policy gaps and achieve treatment scale-up that is comparable to that in adults include: establishment of a campaign on access to testing and treatment that is targeted at children and adolescents; fast-track evaluation of pan-genotypic regimens; and accelerated approval of paediatric formulations. Research gaps that need to be addressed include: age-specific prevalence studies of HCV viraemia in priority countries; further validation of non-invasive tests for staging of liver disease in children; and establishment of paediatric treatment registries and international consortia to promote collaborative research agendas. ? 2019 World Health Organization. Published by Elsevier Ltd. All rights reserved.
SDGs
Other Subjects
aspartate aminotransferase; dasabuvir plus ombitasvir plus paritaprevir plus ritonavir; elbasvir plus grazoprevir; glecaprevir plus pibrentasvir; hepatitis C vaccine; ledipasvir plus sofosbuvir; ombitasvir plus paritaprevir plus ritonavir; ribavirin; sofosbuvir; sofosbuvir plus velpatasvir; alanine aminotransferase; antivirus agent; aspartate aminotransferase; hepatitis B surface antigen; antiviral therapy; clinical trial (topic); disease burden; disease exacerbation; episiotomy; hepatitis C; Hepatitis C virus; human; liver cell carcinoma; liver cirrhosis; liver disease; prevalence; priority journal; Review; sexual transmission; transient elastography; treatment duration; viral clearance; viremia; virus hepatitis; virus transmission; adolescent; blood; child; diagnostic imaging; elastography; female; harm reduction; hepatitis B; practice guideline; pregnancy; pregnancy complication; prevention and control; vertical transmission; Adolescent; Alanine Transaminase; Antiviral Agents; Aspartate Aminotransferases; Child; Clinical Trials as Topic; Elasticity Imaging Techniques; Female; Harm Reduction; Hepatitis B; Hepatitis B Surface Antigens; Humans; Infectious Disease Transmission, Vertical; Liver Cirrhosis; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Infectious
Publisher
Elsevier Ltd
Type
review