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.
Treatment and monitoring of children with chronic hepatitis C in the Pre-DAA era : A European survey of 38 paediatric specialists / G. Indolfi, H. Bailey, D. Serranti, C. Giaquinto, C. Thorne, E. Sokal, D. Debray, M. Girard, C. Feiterna-Sperling, S. Wirth, R. Guidi, G. Verucchi, L. D'Antiga, E. Nicastro, G. Maggiore, S. Trapani, S. Ricci, M. Resti, V. Giacomet, A.R. Benincaso, G. Nebbia, R. Iorio, M. Cananzi, S. Riva, G. Bossi, I. Dodi, V. Nobili, D. Comparcola, S. Garazzino, P.L. Calvo, M. Pokorska-Spiewak, M. Pawlowska, C. Goncalves, I. Goncalves, M. Bals, A.M. Tudor, A. Noguera-Julian, J.T. Ramos, B. Fischler, V. Mclin, M. Brown, D. Kelly, S. Davison, A. Turkova, A. Bamford. - In: JOURNAL OF VIRAL HEPATITIS. - ISSN 1352-0504. - 26:8(2019), pp. 961-968. [10.1111/jvh.13111]
Treatment and monitoring of children with chronic hepatitis C in the Pre-DAA era : A European survey of 38 paediatric specialists
V. Giacomet;
2019
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.File | Dimensione | Formato | |
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