Treatment and monitoring of children with chronic hepatitis C in the Pre-DAA era: A European survey of 38 paediatric specialists


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Indolfi G., Bailey H., Serranti D., Giaquinto C., Thorne C., Indolfi G., ...More

JOURNAL OF VIRAL HEPATITIS, vol.26, no.8, pp.961-968, 2019 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 8
  • Publication Date: 2019
  • Doi Number: 10.1111/jvh.13111
  • Journal Name: JOURNAL OF VIRAL HEPATITIS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.961-968
  • Keywords: direct-acting antivirals, epidemiology, Europe, treatment, vertical transmission, VIRUS-INFECTION, TRANSIENT ELASTOGRAPHY, PLUS RIBAVIRIN, HCV INFECTION, FIBROSIS, EPIDEMIOLOGY, ADOLESCENTS, ALPHA-2A, RATES
  • Ankara University Affiliated: Yes

Abstract

The burden of paediatric Hepatitis C virus (HCV) infection across Europe is unknown, as are current policies regarding monitoring and treatment. This collaborative study aimed to collect aggregate data to characterise the population of <= 18-year-olds with HCV infection in specialist follow up in a 12-month period (2016) across the PENTAHep European consortium, and investigate current policies around monitoring and treatment. A cross-sectional, web-based survey was distributed in April 2017 to 50 paediatricians in 19 European countries, covering patients' profile, and monitoring and treatment practices. Responses were received from 38/50 clinicians collectively caring for 663 children with chronic HCV infection of whom three-quarters were aged >= 6 years and 90% vertically infected. HCV genotype 1 was the most common (n 380; 57.3%), followed by genotype 3, 4 and 2. Seventeen children (3%) with chronic HCV infection were diagnosed with cirrhosis, and six were reported to have received liver transplantation for HCV-related liver disease. The majority (n 425; 64.1%) of the European children with HCV infection remained treatment-naive in 2016. Age affected clinicians' attitudes towards treatment; 94% reported being willing to use direct-acting antivirals, if available, in adolescents (aged >= 11 years), 78% in children aged 6-10 and 42% in those 3-5 years of age (Pearson correlation coefficient -0.98; P 0.0001). This survey provides the largest characterisation of the population of children in clinical follow-up for chronic HCV infection in Europe, alongside important contextual information on their management and treatment. Discussion is needed around strategies and criteria for use of direct-acting antivirals in these children.