Department of Pediatrics, Osaka General Medical Center, Osaka, Japan.
Department of Pediatrics, Graduate School of Medicine, Osaka University, Osaka, Japan.
Pediatr Int. 2022 Jan;64(1):e14962. doi: 10.1111/ped.14962.
The first guidelines for care of pregnant women carrying the hepatitis C virus (HCV) and their infants were published in 2005 in Japan. Since then, evidence has gradually accumulated worldwide regarding the natural course and treatment of this condition and, especially in recent years, treatment for chronic hepatitis C in adult patients has made great progress. However, the clinical practice policy for children has not been standardized, and new clinical practice guidelines for children with mother-to-child (MTC) transmitted HCV infection have become necessary.
In the development of the current guideline, we requested cooperation from The Japanese Society for Pediatric Infectious Diseases, The Japan Society of Hepatology, and the Japan Society of Obstetrics and Gynecology. The committee members were recommended and approved by each society to participate in developing the guidelines. The guideline was also created in accordance with the Minds Guide for Practice Guideline Development. The statements were prepared by consensus-building using the Delphi method, based on the comprehensively searched academic papers and guidelines. These articles were retrieved through searching the PubMed, Cochrane Library, and the Igaku Chuo Zasshi databases.
Eight clinical questions (CQs) with clinical statements were developed regarding etiology (CQs 1-3), diagnosis (CQs 4 and 5), and treatment (two CQs 6 and 7). In each statement, the consensus rate, evidence level, and recommendation level were determined.
The guidelines will be helpful in the management of children with hepatitis C MTC transmission.
2005 年,日本首次发布了针对携带丙型肝炎病毒(HCV)的孕妇及其婴儿的护理指南。此后,全球范围内逐渐积累了有关该病自然病程和治疗的证据,尤其是近年来,慢性丙型肝炎成人患者的治疗取得了重大进展。然而,儿童的临床实践政策尚未标准化,因此有必要制定针对母婴传播 HCV 感染儿童的新临床实践指南。
在制定本指南的过程中,我们请求日本儿科传染病学会、日本肝病学会和日本妇产科协会的合作。委员会成员由各学会推荐并批准参与指南的制定。本指南还按照 Minds 实践指南制定指南的指南制定。根据综合检索的学术论文和指南,使用 Delphi 方法通过共识构建来准备陈述。这些文章是通过在 PubMed、Cochrane Library 和 Igaku Chuo Zasshi 数据库中检索获得的。
针对病因(问题 1-3)、诊断(问题 4 和 5)和治疗(两个问题 6 和 7),制定了 8 个具有临床陈述的临床问题。在每个陈述中,确定了共识率、证据水平和推荐水平。
本指南将有助于管理丙型肝炎母婴传播的儿童。