Chronic hepatitis C virus infection in children and adolescents: Epidemiology, natural history, and assessment of the safety and efficacy of combination therapy
Giuseppe Indolfi, Elisa Bartolini, Davide Casavola, Massimo Resti
Department of Sciences for Women and Child’s Health, Liver and Pediatric Unit, Anna Meyer Children’s Hospital, University of Florence, Florence, Italy
Abstract: Hepatitis C virus (HCV) is the most common cause of chronic liver disease of infectious etiology in children. Most of the children infected with HCV are asymptomatic, and only a few of them develop signs and symptoms of end-stage liver disease early in life. It is not possible to predict either in which patients HCV infection will have a bad outcome or the critical time in early adulthood when disease progression will accelerate. The experiences with therapy in children with chronic hepatitis C are based on earlier and continuing data from adult trials. The currently recommended treatment for chronic HCV infection in adults is the combination of peginterferon-a and ribavirin. The choice of this regimen is based on the results of randomized clinical trials that demonstrated the superiority of this combination treatment over standard interferon-a and ribavirin. Recently, results of pivotal, multicenter, interventional open-label studies on combined treatment with peginterferon-a and ribavirin in children have been published, and the US Food and Drug Administration and the European Medicines Agency have approved the combination therapy in those older than 3 years. The aim of this review is to evaluate critically the available data regarding the safety and efficacy of combination treatment with peginterferon-a and ribavirin in children.
Keywords: treatment, peginterferon, ribavirin, adverse events, sustained viral response
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