Hepatitis C in children: recent advances.

PURPOSE OF REVIEW: Hepatitis C virus infection has recently been recognized as a viral infection with the potential to cause significant complications, including cirrhosis and hepatocellular carcinoma in adults. Changes in our understanding of its natural history in children and recent advances in therapy for acute and chronic hepatitis C are reviewed.

RECENT FINDINGS: Recent work has demonstrated that, although uncommon, vertical transmission is the most frequent mode of hepatitis C acquisition in children and is enhanced in the setting of maternal co-infection with HIV. Chronic hepatitis C during childhood leads in some cases to development of advanced hepatic fibrosis, with complications including liver failure and liver cancer, which has changed our general approach to this infection. Perhaps the most significant recent advance in this area is our improved understanding of the safety and efficacy of interferon-based antiviral therapies for children with hepatitis C.

SUMMARY: Hepatitis C virus infection has reached epidemic proportions worldwide; despite its being less prevalent in children than in adults, it poses a significant clinical problem in this age group. Emerging antiviral therapies are currently in clinical trials for adult patients with hepatitis C with encouraging preliminary results, which should be extended to children.