title: Managing pediatric hepatitis C: current and emerging treatment options.
abstract: Since 1992, the maternal-fetal route of transmission has become the dominant route for acquisition of hepatitis C (HCV) infection by children. With increasing knowledge of antiviral treatment for HCV infection, the main goal of therapy is to achieve a sustained virological response (SVR) as defined by undetectable serum HCV RNA by polymerase chain reaction assay six months after cessation of therapy. In young children, interferon therapy is more effective than in adults with chronic HCV infection (CHC). Although children clearly have a milder degree of liver pathology, data have indicated that hepatic inflammation from HCV infection can progress to fibrosis or cirrhosis in children. Hepatocellular carcinoma has been reported in adolescents with CHC. In this article, recent improvements in therapy of children with CHC and in the clinical development of new emerging drugs with potential use in children will be reviewed.
authors.affiliation: Pediatric Liver Center, Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Wikrom
authors.initials: W
authors.lastname: Karnsakul
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Alford
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Schwarz
references.citation: Antivir Ther. 2004 Dec;9(6):953-68
references.pmid: 15651754
references.citation: J Gastroenterol Hepatol. 2002 Feb;17 Suppl:S146-54
references.pmid: 12000600
references.citation: N Engl J Med. 2009 Apr 30;360(18):1827-38
references.pmid: 19403902
references.citation: J Hepatol. 2002 Dec;37(6):773-80
references.pmid: 12445418
references.citation: Hepatology. 2007 Aug;46(2):324-9
references.pmid: 17654603
references.citation: Hepatology. 2008 Mar;47(3):836-43
references.pmid: 18167062
references.citation: J Pediatr Gastroenterol Nutr. 2006 Oct;43(4):499-505
references.pmid: 17033526
references.citation: J Pediatr Gastroenterol Nutr. 2009 May;48(5):630-5
references.pmid: 19412012
references.citation: Am J Health Syst Pharm. 1999 May 15;56(10):961-73; quiz 974-5
references.pmid: 10365720
references.citation: AIDS Patient Care STDS. 2007 Mar;21(3):154-68
references.pmid: 17428183
references.citation: Expert Opin Investig Drugs. 2009 Jun;18(6):709-25
references.pmid: 19426125
references.citation: Liver Transpl. 2006 Jul;12(7):1119-23
references.pmid: 16799942
references.citation: Clin Liver Dis. 1999 Nov;3(4):793-810
references.pmid: 11291251
references.citation: J Gastroenterol Hepatol. 2008 Jul;23(7 Pt 1):1000-8
references.pmid: 18707597
references.citation: Gastroenterology. 1996 Nov;111(5):1307-12
references.pmid: 8898645
references.citation: Eur J Pediatr. 1999 Apr;158(4):344
references.pmid: 10206141
references.citation: Am J Public Health. 2000 Oct;90(10):1562-9
references.pmid: 11029989
references.citation: Lancet. 1998 Jan 10;351(9096):83-7
references.pmid: 9439491
references.citation: J Pharmacol Exp Ther. 2002 Nov;303(2):540-8
references.pmid: 12388634
references.citation: Virology. 2006 Mar 15;346(2):363-72
references.pmid: 16336987
references.citation: Hepatology. 1997 Aug;26(2):485-90
references.pmid: 9252163
references.citation: BMJ. 2001 Nov 17;323(7322):1151-5
references.pmid: 11711405
references.citation: J Hepatol. 1999;31 Suppl 1:250-4
references.pmid: 10622597
references.citation: Hepatology. 2008 Jan;47(1):35-42
references.pmid: 17975791
references.citation: Digestion. 2000;61(2):90-7
references.pmid: 10705172
references.citation: Ann Surg. 2001 Sep;234(3):384-93; discussion 393-4
references.pmid: 11524591
references.citation: Vaccine. 1999 Mar 26;17(13-14):1730-3
references.pmid: 10194830
references.citation: N Engl J Med. 2009 Apr 30;360(18):1839-50
references.pmid: 19403903
references.citation: Pediatr Infect Dis J. 2000 Jun;19(6):511-6
references.pmid: 10877164
references.citation: Lancet. 2001 Jan 20;357(9251):196-7
references.pmid: 11213099
references.citation: J Pediatr. 2007 Feb;150(2):168-74, 174.e1
references.pmid: 17236895
references.citation: Curr Gastroenterol Rep. 2006 Feb;8(1):46-52
references.pmid: 16510034
references.citation: Obstet Gynecol Surv. 2006 Oct;61(10):666-72
references.pmid: 16978426
references.citation: N Engl J Med. 1998 Nov 19;339(21):1485-92
references.pmid: 9819446
references.citation: Clin Infect Dis. 2005 Jul 1;41(1):45-51
references.pmid: 15937762
references.citation: Hepatology. 2002 Nov;36(5 Suppl 1):S3-20
references.pmid: 12407572
references.citation: Turk J Gastroenterol. 2006 Jun;17(2):94-8
references.pmid: 16830289
references.citation: J Clin Gastroenterol. 2007 Jan;41(1):111-4
references.pmid: 17198073
references.citation: Hepatology. 2005 Sep;42(3):724-31
references.pmid: 16116638
references.citation: J Hepatol. 1999 Oct;31(4):604-11
references.pmid: 10551382
references.citation: Lancet. 1998 Oct 31;352(9138):1426-32
references.pmid: 9807989
references.citation: Hepatology. 2005 May;41(5):1013-8
references.pmid: 15793840
references.citation: Hepatology. 2001 Aug;34(2):223-9
references.pmid: 11481604
references.citation: Blood. 1997 Dec 1;90(11):4628-33
references.pmid: 9373275
references.citation: Nat Clin Pract Gastroenterol Hepatol. 2007 Jan;4 Suppl 1:S17-21
references.pmid: 17235281
references.citation: Arch Dis Child Fetal Neonatal Ed. 2005 Mar;90(2):F156-60
references.pmid: 15724041
references.citation: Hepatology. 2002 Nov;36(5 Suppl 1):S173-8
references.pmid: 12407591
references.citation: Clin Pharmacol Ther. 2000 Nov;68(5):556-67
references.pmid: 11103758
references.citation: Transfusion. 2007 Apr;47(4):615-20
references.pmid: 17381619
references.citation: J Pediatr Gastroenterol Nutr. 2009 Mar;48(3):341-7
references.pmid: 19242286
references.citation: Expert Rev Vaccines. 2005 Jun;4(3):351-71
references.pmid: 16026249
references.citation: Liver Transpl. 2000 Sep;6(5):553-61
references.pmid: 10980053
references.citation: J Viral Hepat. 2008 Jan;15(1):2-11
references.pmid: 18088238
references.citation: Expert Rev Vaccines. 2009 Mar;8(3):333-45
references.pmid: 19249975
references.citation: Pediatr Infect Dis J. 2002 May;21(5):479-81
references.pmid: 12150196
references.citation: Liver Int. 2009 Jan;29 Suppl 1:74-81
references.pmid: 19207969
references.citation: Lancet. 1995 Oct 21;346(8982):1051-5
references.pmid: 7564784
references.citation: J Hepatol. 2005 Sep;43(3):515-25
references.pmid: 16144064
references.citation: Drugs. 2001;61(11):1661-91
references.pmid: 11577799
references.citation: Clin Trials. 2007;4(6):661-73
references.pmid: 18042575
references.citation: Vaccine. 2004 Aug 13;22(23-24):3080-6
references.pmid: 15297058
references.citation: J Pediatr Gastroenterol Nutr. 2002 Jan;34(1):52-8
references.pmid: 11753165
references.citation: Liver Transpl. 2003 Mar;9(3):228-35
references.pmid: 12619018
references.citation: Hepatology. 1998 Apr;27(4):1136-43
references.pmid: 9537455
references.citation: Curr Oncol Rep. 2003 Mar;5(2):108-13
references.pmid: 12583827
references.citation: Hepatology. 2002 Nov;36(5 Suppl 1):S106-13
references.pmid: 12407583
references.citation: J Infect Dis. 2003 Feb 1;187(3):345-51
references.pmid: 12552417
references.citation: Hepatology. 2002 Nov;36(5):1280-4
references.pmid: 12395341
references.citation: Gastroenterol Clin Biol. 2007 Aug-Sep;31(8-9 Pt 3):4S29-33
references.pmid: 17965632
references.citation: J Gastroenterol Hepatol. 2008 Jun;23(6):844-55
references.pmid: 18565019
references.citation: J Pediatr. 2006 Mar;148(3):353-8
references.pmid: 16615966
references.citation: Future Microbiol. 2009 May;4(4):391-5
references.pmid: 19416008
references.citation: Clin Gastroenterol Hepatol. 2009 Apr;7(4):397-414; quiz 366
references.pmid: 19114127
references.citation: World J Gastroenterol. 2006 Sep 28;12(36):5787-92
references.pmid: 17007043
references.citation: Can J Gastroenterol. 2003 Aug;17(8):479-82
references.pmid: 12945008
references.citation: Hepatology. 2009 Jun;49(6):1838-46
references.pmid: 19291790
references.citation: J Viral Hepat. 2009 Nov;16(11):796-801
references.pmid: 19413696
references.citation: J Viral Hepat. 2001 Mar;8(2):120-31
references.pmid: 11264732
references.citation: Gastroenterology. 2008 Jun;134(7):1900-7
references.pmid: 18439604
references.citation: Hepatology. 1998 Dec;28(6):1696-701
references.pmid: 9828237
references.citation: Semin Liver Dis. 2000;20(1):1-16
references.pmid: 10895428