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Treatment and Monitoring of Children with Chronic Hepatitis C in the Pre-DAA Era: a European Survey of 38 Paediatric Specialists

Indolfi, G; Bailey, H; Serranti, D; Giaquinto, C; Thorne, C; PENTAHep Study Group, ; (2019) Treatment and Monitoring of Children with Chronic Hepatitis C in the Pre-DAA Era: a European Survey of 38 Paediatric Specialists. Journal of Viral Hepatitis , 26 (8) pp. 961-968. 10.1111/jvh.13111. Green open access

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Abstract

The burden of paediatric HCV infection across Europe is unknown, as are current policies regarding monitoring and treatment. This collaborative study aimed to collect aggregate data to characterise the population of ≤18‐year olds with HCV infection in specialist follow up in a twelve‐month period (2016) across the PENTAHep European consortium, and investigate current policies around monitoring and treatment. A cross‐sectional, web‐based survey was distributed in April 2017 to 50 paediatricians in 19 European countries, covering patients’ profile, and monitoring and treatment practices. Responses were received from 38/50 clinicians collectively caring for 663 children with chronic HCV infection of whom three‐quarters were aged ≥6 years and 90% vertically‐infected. HCV genotype 1 was the most common (n 380; 57.3%), followed by genotype 3, 4 and 2. Seventeen children (3%) with chronic HCV infection were diagnosed with cirrhosis and 6 were reported to have received liver transplantation for HCV‐related liver disease. The majority (n 425; 64.1%) of the European children with HCV infection remained treatment‐naive in 2016. Age affected clinicians’ attitudes towards treatment; 94% reported being willing to use direct‐acting antivirals, if available, in adolescents (aged ≥11 years), 78% in children aged 6‐10 and 42% in those 3 to 5 years of age (Pearson correlation coefficient ‐0.98; p 0.0001). This survey provides the largest characterisation of the population of children in clinical follow‐up for chronic HCV infection in Europe, alongside important contextual information on their management and treatment. Discussion is needed around strategies and criteria for use of direct‐acting antivirals in these children.

Type: Article
Title: Treatment and Monitoring of Children with Chronic Hepatitis C in the Pre-DAA Era: a European Survey of 38 Paediatric Specialists
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jvh.13111
Publisher version: https://doi.org/10.1111/jvh.13111
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Europe, direct-acting antivirals, epidemiology, treatment, vertical transmission
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10072716
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