Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2021; 27(12): 1117-1131
Published online Mar 28, 2021. doi: 10.3748/wjg.v27.i12.1117
Cascade of care for children and adolescents with chronic hepatitis C
Michael Evan Rogers, William F Balistreri
Michael Evan Rogers, William F Balistreri, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States
Author contributions: Rogers ME is the first author; Balistreri W is the lead and corresponding author; all authors helped in research, write, and edit the final review manuscript.
Conflict-of-interest statement: Dr. Balistreri was an investigator for ABBVIE, GILEAD, and MERCK clinical trials; Dr. Rogers has no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: William F Balistreri, FAASLD, MD, Doctor, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, United States.
Received: December 21, 2020
Peer-review started: December 21, 2020
First decision: January 10, 2021
Revised: January 19, 2021
Accepted: March 11, 2021
Article in press: March 11, 2021
Published online: March 28, 2021

Chronic hepatitis C virus (HCV) infection presents a significant global public health burden. In 2015, over 400000 deaths worldwide were attributed to HCV infection. This led the World Health Organization (WHO) in 2016 to set the ambitious goal of eliminating HCV by 2030. Adult-centered guidelines have been established in order to provide direction for healthcare professionals, allowing integration of the newest screening policies and therapeutic strategies into their practices. However, for children and adolescents, HCV is a significant, unrecognized public health problem. HCV infection rates in the United States in women of childbearing age and those who are pregnant have increased in parallel with the rising opioid epidemic. An estimated 29000 women with HCV infection gave birth each year from 2011 to 2014 in the United States, with approximately 1700 of their infants being infected with HCV. Newer HCV-specific therapeutics, namely direct acting antivirals (DAA), has brought a new and highly successful approach to treatment of hepatitis C. Recent studies have confirmed similar levels of effectiveness and safety of DAA therapies in the pediatric population. Thus, an enhanced cascade of care, which should include the population under 18 years of age, can help achieve the WHO goal by focusing on elimination in the youngest populations. This review will present an overview of the natural history, clinical features, and management of HCV in children and adolescents.

Keywords: Hepatitis C virus, Hepatitis C education, Hepatitis C elimination

Core Tip: In 2020, the landmark series of accomplishments which started with the discovery of the hepatitis C virus (HCV) and led to the development of pharmaceutical agents capable of curing HCV infection was underscored by the awarding of the Nobel Prize in Medicine. These innovative cures are now being applied to the pediatric population. Furthermore, programs such as The Kentucky Hepatitis Academic Mentorship Program have been developed to train general pediatricians on HCV epidemiology, diagnosis, management, treatment and prevention. Thus this cascade of care will hopefully help achieve the World Health Organization goal of eliminating HCV by 2030.