Management of pediatric HCV

ABSTRACT

Hepatitis C viral [HCV] infection is emerging as a challenge to the developing and affluent nations alike including the pediatric population. With universal pretransfusion screening for HCV, the major focus of pediatric HCV disease has shifted to the study of natural course and management of perinatally acquired HCV disease. In contrast to the favorable change of trend in the developed countries, sharing of contaminated needles and instruments, unprotected sex and occupational exposure continue to be a significant source of transmission in developing countries like Pakistan. Similarly, there is a lack of epidemiological data and a new sense of urgency in the healthcare community about the burden of the pediatric HCV disease for the local population in Pakistan. In general, the course of HCV infection is deceptively benign during childhood followed by complications during later life including hepatocellular carcinoma [HCC] and end stage liver disease. Interferon and more recently Pegylated-interferon [PEG-INF] with ribavirin has gained popularity as the treatment modalities in adults. However, there is lack of consensus guidelines for screening and management of HCV during childhood. Cost is an additional barrier to pharmacotherapy in developing countries. This review focuses on the natural history, diagnostic modalities and approach to the management of HCV in pediatric age group