Hepatitis C virus (HCV) infection may occur in infants and children, althou
gh it is much less common than it is in adults. The main transmission route
s include mother-to-infant transmission, use of HCV infected blood products
, unsterile needles or syringes and other invasive procedures.
The natural course of HCV infection in children is variable: some (20-40%)
develop an acute resolving infection and spontaneous regression occurs in a
pproximately one-third of infants of HCV infected mothers before 2 years of
age. Approximately 60-80% of HCV infected children develop a chronic infec
tion with varying degrees of activity and fibrosis, mostly mild during chil
dhood. However, the potential risks of liver cirrhosis and hepatoma during
later life are obvious.
Interferon is the main agent used to treat HCV infection in children. The r
esponse to interferon at the end of 4-12 months of therapy ranges from 25-9
0%. A sustained response was found in 36-56% of children 6-36 months after
the end of therapy. The duration of therapy is recommended to be 12 months.
At the end of 3 months, an evaluation of the response is indicated in the
majority of children, except those with thalassemia, in whom evaluation of
response should be conducted at the end of 6 months of therapy.
The benefit of other therapies, such as combination therapy with interferon
and ribavirin in children with hepatitis C is currently under investigatio
n.