Transmission, natural history, and treatment of hepatitis C virus infection in the pediatric population

Compared with the adult population, hepatitis C Virus infection may differ in the pediatric age group with respect to transmission, course, and respon se to treatment, The prevalence of hepatitis C in children is between 0.05% and 0.4%. The major mode of acquisition has shifted from parenteral transm ission to maternal-infant transmission. However, the actual rate of materna l-infant transmission is low. The natural history of hepatitis C in childre n is not well characterized, although the available information suggests a milder disease than in adults, In the eight studies of treatment with inter feron for hepatitis C in children, the incidence of a complete sustained re sponse varied from 0 to 45%, No pediatric studies have evaluated quality of life or the effect of treatment on the development of cirrhosis and hepato cellular carcinoma. Children may respond better to treatment than adults. W e recommend that children with hepatitis C are considered for treatment onl y as part of a controlled clinical trial.