6533b858fe1ef96bd12b6df6

RESEARCH PRODUCT

Management of chronic hepatitis C in childhood: The impact of therapy in the clinical practice during the first 2 decades

Raffaella GiacchinoCristiana BarberaMaria GuidoGiuseppe IndolfiMaria Grazia MarazziFlavia BortolottiLucia ZancanGabriella VerucchiCalogero CammàMassimo Resti

subject

Malemedicine.medical_specialtyAdolescentGenotypeCombination therapyHepatitis C virusNatural historyCHILDRENHepacivirusInterferon alpha-2medicine.disease_causeAntiviral AgentsTHERAPYPolyethylene Glycolschemistry.chemical_compoundChronic hepatitisHepatitis C virus RNAInternal medicineRibavirinmedicineHumansChildRetrospective StudiesHepatologyHepatitis C virusbusiness.industryRibavirinGastroenterologyInfantInterferon-alphaCHRONIC HEPATITISHepatitis C ChronicRecombinant ProteinsTreatmentNatural historyClinical PracticeSustained virological responseChildren; Hepatitis C virus; Natural history; Sustained virological response; TreatmentchemistryViral replicationChild PreschoolHCVImmunologyRNA ViralDrug Therapy CombinationFemaleInterferonsbusiness

description

Background and aim: Treatment of chronic hepatitis C in children is controversial and its role in the clinical practice is unknown. We retrospectively investigated the impact of treatment in a large cohort of children with chronic hepatitis C over the past 20years. Methods: 376 hepatitis C virus RNApositive children were recruited consecutively in five Italian centres since 1990and followed for1–17years. Results: 86 (23%)subjects were treated: 73 with recombinant interferon alone and 13 with pegylated-interferon and ribavirin. Sustained clearance of hepatitis C virus RNA was observed in 25%of the former, in 92%of the latter and in 9% of untreated cases(p < 0.001). Loss of viraemia was recorded in all children with genotype2–3 and in 6of7 with hepatitis C virus genotype 1 treated with combination therapy.At last evaluation 45% of patients were young adults and 15%had cleared viraemia. Overall, 152 (40%)were putative candidates to therapy. Conclusions: Few Italian children with chronic hepatitis C have been treated in the past 20years.The poor propensity to spontaneous clearance of viraemia and the efficacy of ombination therapy should encourage to consider treatment in attempt to shorten the duration of viral replication.

yearjournalcountryeditionlanguage
2011-01-01Digestive and Liver Disease
https://doi.org/10.1016/j.dld.2010.10.008