title: Interferon-α plus ribavirin yields 98 % sustained virologic response in children aged 1-5 years with iatrogenic chronic hepatitis C.
abstract: OBJECTIVE
  The clinical features and efficacies of antivirals for children with hepatitis C virus (HCV) infections that are acquired through different transmission routines are poorly understood worldwide. This study investigated the clinical characteristics of children who were infected via iatrogenic means and analyzed the efficacy of antiviral therapy in children with chronic hepatitis C (CHC).
  
  
  METHODS
  In total, 256 children with HCV infections aged 1 to 5 years were enrolled and surveyed. Interferon-α plus ribavirin was administered to 162 children with CHC for 24 or 48 weeks. The sustained virologic response (SVR) at 24 weeks post-treatment was determined.
  
  
  RESULTS
  The median duration of infection was 11.5 (range 6-24) months. The median age was 2.7 years, and 64.5 % of the subjects were male. Ninety-three children (36.3 %, 93/256) exhibited spontaneous resolution of the HCV infection. The remaining 163 (63.7 %) were HCV RNA-positive and had HCV genotypes 1b and 2a, which were identified in 42 and 58 %, respectively, of the 133 tested children. Liver biopsies were performed in all HCV RNA-detectable children. A total of 23.9 % cases exhibited grade 2 activity, and 30.1 % exhibited stage 2/3 liver fibrosis. The serum HCV RNA levels were positively correlated with the aminotransferases. Of the 162 treated CHC children, 158 (97.5 %) achieved SVR. The side effects were mild, and 158 (97.5 %) of the treated patients tolerated the treatment well.
  
  
  CONCLUSIONS
  This study revealed that histological liver disease can be present within 6-24 months of acquiring an HCV infection in children aged 1-5 years. Interferon-α plus ribavirin therapy is a highly effective and cost-effective means of managing children with early-stage chronic HCV infection.
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Shi-Shu
authors.initials: SS
authors.lastname: Zhu
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.|The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Qing-Lei
authors.initials: QL
authors.lastname: Zeng
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Xu
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Wang
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Chen
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gan
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Fu-Chuan
authors.initials: FC
authors.lastname: Wang
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Yan
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Cao
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Pu
authors.initials: P
authors.lastname: Wang
authors.affiliation: Genetic Testing Center, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Han
authors.affiliation: The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Xue-Xiu
authors.initials: XX
authors.lastname: Zhang
authors.affiliation: The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Treatment and Research Center for Children's Liver Disease, Beijing 302 Hospital, Beijing, 100039, China. bjzhhf@aliyun.com.
authors.forename: Hong-Fei
authors.initials: HF
authors.lastname: Zhang
authors.affiliation: The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, 100039, China. fswang302@163.com.
authors.forename: Fu-Sheng
authors.initials: FS
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D007223:Infant; D016898:Interferon-alpha / Q000008:administration & dosage*; D008099:Liver / Q000473:pathology; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin
keywords: Antiviral therapy; Children; Epidemiology; Hepatitis C virus; Iatrogenic infection