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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2018; 24(24): 2555-2566
Published online Jun 28, 2018. doi: 10.3748/wjg.v24.i24.2555
Hepatitis C virus infection in children in the era of direct-acting antiviral
Krzysztof Domagalski, Malgorzata Sobolewska-Pilarczyk, Malgorzata Pawlowska
Malgorzata Pawlowska, Malgorzata Sobolewska-Pilarczyk, Department of Paediatric Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz 85-030, Poland
Krzysztof Domagalski, Centre For Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń 87-100, Poland
Author contributions: Pawlowska M, Sobolewska-Pilarczyk M and Domagalski K 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 Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Torun, Floriana 12, Bydgoszcz 85-030, Poland. mpawlowska@cm.umk.pl
Telephone: +48-52-3255605 Fax: +48-52-3255650
Received: March 27, 2018
Peer-review started: March 27, 2018
First decision: April 19, 2018
Revised: May 10, 2018
Accepted: June 2, 2018
Article in press: June 2, 2018
Published online: June 28, 2018
Abstract

Hepatitis C virus (HCV) infection remains an important global health problem with chronic infection affecting approximately 11 million children worldwide. The emergence of direct-acting antiviral (DAA) therapies and the development of non-invasive methods for the determination of liver fibrosis will significantly improve the management of paediatric patients with chronic HCV infection in subsequent years. For paediatric patients, a new era of highly effective DAA agents is beginning, and the first results of available clinical trials are very promising. In this era, the identification and monitoring of patients continues to be an important issue. The availability of non-invasive serological and imaging methods to measure hepatic fibrosis enables the identification of patients with significant or advanced liver fibrosis stages. This article summarizes the current data on the epidemiology and progress of research aimed to evaluate the new therapies and non-invasive methods for liver injury in paediatric patients with chronic hepatitis C.

Keywords: Biomarkers of liver injury, Adolescents, Epidemiology, Direct-acting antiviral, Hepatitis C virus, Non-invasive methods, Children

Core tip: There are more than 11 million hepatitis C virus (HCV)-infected children worldwide. Most new HCV-infected cases have occurred through vertical transmission. Currently, a new era of highly effective direct-acting antiviral agents for the treatment of HCV infection has begun for paediatric patients. The first results of clinical trials with interferon-free therapy are very promising. ESPGHAN developed a position paper for the management of chronic HCV infection in children. Non-invasive methods to measure hepatic fibrosis enable the identification of patients with significant liver fibrosis. This article summarizes the current data on epidemiology, new therapies and non-invasive methods in paediatric patients with HCV infection.