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Perinatal Exposure to HCV Leads to Earlier Cirrhosis

Samantha DiGrande
A recent retrospective review of patients who contracted hepatitis C (HCV) in childhood found that those with perinatal infection developed cirrhosis earlier than other risk groups.
A recent retrospective review of patients who contracted hepatitis C (HCV) in childhood found that those with perinatal infection developed cirrhosis earlier than those in other risk groups.

The study, published in the Journal of Hepatology, reviewed data from 1049 patients whose first HCV infection occurred between birth and 18 years of age. Patients were infected through either intravenous drug use (53%), infected blood products (24%), perinatal exposure (11%), or unknown causes (12%).

“Chronic HCV infection is a global health problem, which can now be treated with potent directly acting antiviral drugs,” wrote the authors.

Liver disease developed in 32% of patients at a median of 33 years irrespective of the mode of infection. The median time between diagnosis and HCV infection was between 19 and 24 years for the intravenous drug group, the infected blood product group, and the unknown risk group, compared with 2 years for the perinatal group.

At the time of review, 334 patients received a diagnosis of cirrhosis. Two risk factors identified to have a correlation with the development of cirrhosis included male sex (odds ratio [OR], 1.6; 95% CI, 1.2-2.2) and heavy alcohol use (OR, 1.6; 95% CI, 1.2-2.8).

Among 502 patients who had full data available, including HCV treatment and follow up, 87 patients experienced disease progression, which was more common in those with cirrhosis than without (28% vs 13%, respectively; P <.001). Additionally, treatment was more effective in those without cirrhosis and disease progression was less common (13%) compared with those who had cirrhosis at the time of therapy (28%) (P <.001).

“HCV infection in young people causes significant liver disease,” wrote the authors. “Early treatment, especially before development of cirrhosis, is essential. Detection of HCV should be aimed at relevant risk groups and antiviral therapy should be made available in childhood to prevent long-term liver disease and spread of HCV.”

Reference

Modin L, Arshad A, Wilkes B, et al. Epidemiology and natural history of hepatitis C virus infection among children and young people [published online November 26, 2018]. J Hepatol. doi: 10.1016/j.jhep.2018.11.013.

 
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