Jared Kaltwasser MD Magazine
The study, highlighting the importance of testing and early intervention in young patients with HCV, helps clinicians quantify the means by which infection is occurring in children.
Investigators from Birmingham Women and Children’s Hospital and Nottingham University Hospital NHS Trust analyzed data from the HCV Research UK database, finding 1049 enrollees who were diagnosed with HCV as a child. They found that most of the patients had contracted the virus through the use of intravenous drugs (52%), and the next-largest category contracted the disease via blood products (24%). Another 11% contracted the virus through perinatal infection.
William L. Irving, PhD, a professor of virology at the University of Nottingham, said he was surprised to see that liver disease appears to progress at the same rate regardless of whether the person is infected at an advanced age, or at birth.
“There would be reasons for thinking this might not be true, because those individuals [infected at birth] would not have the same co-factors for disease progression as older children and adults, most obviously alcohol consumption,” he told MD Magazine®, “and yet for the small numbers of cases that we were able to follow, cirrhosis developed at roughly the same interval after infection as it did for the children who acquired infection through drug use.”
Among the patients enrolled in the study and diagnosed in childhood, 663 patients received treatment and three-quarters of those achieved sustained virological response (SVR). Of those receiving treatment, 55% were given interferon/Peg interferon therapy, and 40% were given direct-acting antivirals (DAAs).
Achieving SVR was shown to be a significant milestone in terms of later health outcomes. Mortality rates among patients achieving SVR was just 1%, versus 5% for patients without SVR.
Line Modin, MD, PhD, who at the time was at Birmingham Women and Children’s Hospital but who now works at the Hans Christian Andersen Children’s Hospital, in Denmark, noted that regulators in the US and Europe have approved certain HCV therapies for children. Sofosbuvir and ribavirin were approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) earlier this year for the treatment of children ages 12-17. The EMA has also approved ledipasvir/sofosbuvir (Harvoni) for children over 12.
However, she noted that that approval has not yet translated into access everywhere in Europe.
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