Natural History and Management of Hepatitis C in Children 25 Years Experience of a Reference Center in Northern Italy

被引:0
作者
Musto, Francesca [1 ]
Stracuzzi, Marta [1 ]
Crivellaro, Elisa [1 ]
Rubinacci, Valeria [1 ]
Cibarelli, Alessandro [1 ]
Porro, Cecilia [1 ]
Ghidoni, Elena [1 ]
Zuccotti, Gian Vincenzo [2 ,3 ]
Giacomet, Vania [1 ]
机构
[1] Univ Milan, Luigi Sacco Hosp Milan, Dept Paediat, Paediat Infect Dis Unit, Via Giovanni Battista Grassi, Milan, Italy
[2] Buzzi Childrens Hosp, Pediat Dept, Milan, Italy
[3] Univ Milan, Pediat Clin Res Ctr Romeo Enr Invernizzi, Dept Biosci, Milan, Italy
关键词
hepatitis C; direct antiviral agents; elastography; children; TRANSIENT ELASTOGRAPHY; LIVER FIBROSIS; HIV/HCV COINFECTION; CHILDREN; VIRUS; ADOLESCENTS; CHILDHOOD; DIAGNOSIS;
D O I
10.1097/INF.0000000000004374
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Hepatitis C virus (HCV) infection natural history and management in the pediatric population are still debated. We retrospectively evaluated the outcome of a HCV pediatric population managed at the Pediatric Infectious Disease Unit of Luigi Sacco Hospital (Milan, Italy) from January 1997 to January 2022 (median follow-up 10 years) and we focused on the role of new drugs and transient elastography. Fifty-seven patients were enrolled: 8 (14%) had a spontaneous clearance, 33 were treated (58%), 7 (12%) were not treated because they were under 12 years old and 9 were lost at follow-up. HCV RNA was undetectable in all treated patients at the end of therapy, after 12 weeks (SVR12) and for the rest of their follow-up. All patients treated underwent elastography before and 1 year after therapy. Median stiffness pretherapy was 5.6 kPa, and 9 patients (16%) had abnormal transient elastography (>7 kPa, median 8.7 kPa). Median stiffness after treatment in the abnormal group was 6.8 kPa. Direct-acting antiviral agents are a safe and effective therapy for HCV chronic infection in the pediatric population. Liver elastography is normal in many vertically infected children before 12 years, but, when abnormal, it shows a significant improvement after direct-acting antiviral agent treatment. Further studies are needed to evaluate the role of elastography at diagnosis and follow-up in children.
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页码:813 / 818
页数:6
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