Hepatitis C infection in children

Hepatitis C infection is a global health problem. Maternal to fetal transmission is the major route of infection in children, and these children are less likely to clear the infection spontaneously. Most children are asymptomatic with mildly abnormal transaminases. Histological damage is mild in childhood, but the extent of fibrosis correlates with age and duration of infection, therefore continuous monitoring of infected children is recommended. Early consideration of treatment of children with chronic infection is recommended to prevent disease progression. The standard of care regimens using pegylated interferon in combination with ribavirin have been shown to be effective and well tolerated by the paediatric population. However these treatment regimens are long, relatively toxic and expensive. In addition, in approximately half of the patients with genotype 1, treatment remains unsuccessful. Therefore the evaluation of new drugs such as direct acting antivirals is required.