Chair of Infectious Diseases and Hepatology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Med Sci Monit. 2012 Dec;18(12):CS113-6. doi: 10.12659/msm.883620.
Perinatal HCV transmission appears to be an important cause of HCV in children. Treatment of chronic hepatitis C in young children is controversial because of spontaneous HCV clearance and possible adverse events.
Vertical HCV genotype 1 infection was diagnosed in a 3-month-old infant. In the subsequent clinical examination we still observed hepatomegaly, fluctuations of ALT, AST and GGT activity, with the highest values 2206 U/L, 1319 U/L, and 297 U/L, respectively. In qPCR, HCV RNA was >700.000 IU/ml. In the 42nd week of observation, liver biopsy was performed with Grade 1 grading and Grade 1 staging. At age 12 months, interferon-alpha2b (1.5 MU 3 times a week) and ribavirin (2×80 mg daily) were administered for 48 weeks. At the beginning of the treatment we observed fever after IFN injection. In the 12th week of therapy, HCV RNA disappeared followed by SVR, and it was sustained for 6 years. To our knowledge, this is the first report of a pediatric (1-year-old) patient treated with combined IFN alpha-2b and ribavirin therapy.
This case report confirms the possibility of successful anti-HCV treatment in a young child, with 6-year sustained virological response without significant adverse events.
围产期 HCV 传播似乎是儿童 HCV 的一个重要原因。由于自发清除 HCV 和可能发生不良事件，因此对于幼儿慢性丙型肝炎的治疗存在争议。
一名 3 个月大的婴儿被诊断为垂直 HCV 基因型 1 感染。在随后的临床检查中，我们仍观察到肝肿大、ALT、AST 和 GGT 活性波动，最高值分别为 2206 U/L、1319 U/L 和 297 U/L。qPCR 中，HCV RNA >700.000 IU/ml。在观察的第 42 周，进行了肝活检，分级为 1 级，分期为 1 级。在 12 个月龄时，给予干扰素-α2b（每周 3 次，每次 1.5 MU）和利巴韦林（每日 2×80 mg）治疗 48 周。在治疗开始时，我们观察到 IFN 注射后发热。在治疗的第 12 周，HCV RNA 消失，随后出现 SVR，并持续了 6 年。据我们所知，这是首例接受联合 IFN-α2b 和利巴韦林治疗的儿科（1 岁）患者的报告。
本病例报告证实了在幼儿中成功进行抗 HCV 治疗的可能性，6 年持续病毒学应答，无明显不良事件。
