Anti-HCV Therapy Made Available in Childhood Prevents Long-Term Liver Disease

boy holding pills and glass of water, taking medicine
boy holding pills and glass of water, taking medicine
Early treatment, especially before development of cirrhosis, significantly decreases morbidity and mortality associated with HCV infection.

Antiviral therapy for hepatitis C virus (HCV) should be administered to infected children to prevent long-term liver disease and the spread of HCV, according to a retrospective study published in the Journal of Hepatology.1

Chronic HCV infection is a global health problem affecting approximately 71 million people worldwide and is a leading cause of end-stage liver disease, cirrhosis, and liver cancer.2-7 Chronic HCV with a lifetime risk for liver disease develops in most children infected with HCV,8 although it is not known whether infection in early life carries a different risk for progressive disease than infection in adulthood.9,10

Therefore, researchers in the United Kingdom identified 1049 patients infected with HCV and found that HCV infection in childhood caused serious liver disease in 32% of patients at a median age of 33 years, irrespective of age, mode, and route of infection.1 They also found that cirrhosis developed in those with perinatal exposure at an earlier age than in the remainder of the risk groups.

The most common routes of infection in those less than 18 years old were determined to be intravenous drug use (53%), the use of blood or blood products (24%), and by perinatal transmission (11%).

The incidence of hepatocellular carcinoma was 5%, liver transplant was performed in 4%, and death occurred in 3%. Researchers determined that the disease outcome was better for patients who were treated before the development of advanced liver disease.

The authors concluded that, “Pharmacological treatment of chronic HCV in childhood should be provided to children by health authorities based on the present evidence of increased risk of serious liver disease in adulthood.”1

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  1. Modin L, Arshad A, Wilkes B, et al. Epidemiology and natural history of hepatitis C virus infection among children and young people [published online November 27, 2018]. J Hepatol. doi: 10.1016/j.jhep.2018.11.013
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