Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
Warsaw's Hospital for Infectious Diseases, Warsaw, Poland.
Klin Padiatr. 2021 Sep;233(5):211-215. doi: 10.1055/a-1304-3542. Epub 2020 Dec 18.
Chronic hepatitis C (CHC) is a global health burden. Mother-to-child transmission (MTCT) accounts for most HCV infections in pediatric patients. Spontaneous viral clearance may occur in early childhood but is uncommon thereafter. Infection is usually asymptomatic during childhood, although without an effective treatment, vertically infected children may develop serious liver complications including cirrhosis and hepatocellular carcinoma in adulthood. Despite the lack of vaccine against hepatitis C and effective post-exposure methods of prevention of MTCT, treatment with direct-acting antiviral agents (DAAs) raised the prospect of eliminating HCV on a population level. Highly effective, well-tolerated, oral, and interferon-free regimens of short duration have revolutionized treatment of CHC. However, access to these therapies might be limited because of its high cost. In this review, we provide the current state of knowledge on the epidemiology, testing, monitoring and treating of HCV in children. We outline the remaining gaps in therapy and barriers to disease eradication.
慢性丙型肝炎（CHC）是全球健康负担。母婴传播（MTCT）占儿科患者 HCV 感染的大多数。自发性病毒清除可能发生在幼儿期，但此后并不常见。感染在儿童期通常无症状，尽管没有有效的治疗方法，垂直感染的儿童可能在成年后发展为严重的肝脏并发症，包括肝硬化和肝细胞癌。尽管缺乏针对丙型肝炎的疫苗和有效的 MTCT 暴露后预防方法，但直接作用抗病毒药物（DAAs）的治疗提高了在人群层面消除 HCV 的前景。高效、耐受性好、口服、无干扰素的短期疗程彻底改变了 CHC 的治疗方法。然而，由于其高成本，这些治疗方法的获得可能受到限制。在这篇综述中，我们提供了关于儿童 HCV 的流行病学、检测、监测和治疗的最新知识。我们概述了治疗方面的剩余差距和消除疾病的障碍。
