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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2015; 21(38): 10783-10789
Published online Oct 14, 2015. doi: 10.3748/wjg.v21.i38.10783
What’s new in hepatitis C virus infections in children?
Malgorzata Pawlowska, Krzysztof Domagalski, Anna Pniewska, Beata Smok, Waldemar Halota, Andrzej Tretyn
Malgorzata Pawlowska, Anna Pniewska, Beata Smok, Waldemar Halota, Department of Paediatric Infectious Diseases and Haepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland
Krzysztof Domagalski, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, 87-100 Toruń, Poland
Andrzej Tretyn, Department of Plant Physiology and Biotechnology, Nicolaus Copernicus University, 87-100 Toruń, Poland
Author contributions: Pawlowska M, Domagalski K, Pniewska A, Smok B, Halota W and Tretyn A contributed in writing and reviewing this article; all authors approved the final version.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Malgorzata Pawlowska, MD, PhD, Professor, Department of Paediatric Infectious Diseases and Haepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University, Floriana 12, 85-030 Bydgoszcz, Poland. mpawlowska@cm.umk.pl
Telephone: +48-52-3255605 Fax: +48-52-3255650
Received: April 3, 2015
Peer-review started: April 4, 2015
First decision: June 2, 2015
Revised: June 17, 2015
Accepted: September 2, 2015
Article in press: September 2, 2015
Published online: October 14, 2015
Abstract

The number of hepatitis C virus (HCV) infection cases is relatively low in children. This low number may be connected with the lack of screening tests and the asymptomatic course of infection. Currently, mother-to-infant transmission is the most common cause of HCV infection amongst children in developed countries. It is important to introduce routine screening tests for HCV in pregnant women. The risk of vertical transmission of HCV is estimated at approximately 5% (3%-10%). Currently, we do not have HCV transmission prevention methods. Some factors could potentially be eliminated by elective caesarean section. Currently, the method of prevention of perinatal HCV infection is the early identification and effective treatment of infections in young women in the preconception period. We describe genetic tests (IL-28B single nucleotide polymorphisms) to identify children with an increased chance of spontaneous clearance or sustained virologic response achievement and vitamin D level as a potential predictor of treatment response in children. It is also important to develop non-invasive tests that can predict liver fibrosis. The existence of differences in the mechanisms leading to liver injury between children and adults creates new perspectives of action to reduce liver disease progression in children in the early years of life.

Keywords: Hepatitis C virus, Infection in children, Single nucleotide polymorphisms, Epidemiology, Biomarkers of liver injury, Vertical infection

Core tip: Vertical transmission (VT) is the most common cause of hepatitis C virus (HCV) infection in children. It is important to introduce routine HCV screening tests in pregnant women. Some hopes for VTC prophylaxis are associated with directly acting antiviral agents. IL-28B single nucleotide polymorphisms may help to identify children with spontaneous clearance and with good treatment prognosis. Developing non-invasive tests that can predict liver fibrosis in children is important. New biomarkers of liver injury (ITIH4, C4a, arginase 1) have been shown to reflect liver fibrosis and steatosis. The differences in liver injury between children and adults create new perspectives of action to reduce liver disease progression in children.