Российское сообщество больных Гепатитом С


Children with chronic hepatitis cannot be treated simply like miniature adults. Specific issues and questions need to be addressed when dealing with the pediatric age group.

Pediatric patients are less likely than adults to have symptoms of infection with hepatitis C, leaving the viruses undetected and possibly unknowingly spread. According to information available on the natural history of HCV, the percentage of children who become chronic and the long-term outcomes are similar to the percentage of adults. Children who are chronic carriers of HCV have normal growth patterns.

Liver biopsy appears to be less valuable in children than adults.

Chronic hepatitis rarely progresses to cirrhosis in children.

In 16 HCV children followed for up to 14 years, encephalopathy (mental confusion), ascites (swollen stomach), or bleeding did not develop. The lack of cirrhosis in children with HCV is consistent that a time period of 10 to 20 years or more is required for cirrhosis to occur. Hepatocellular carcinoma occurs very rarely in the pediatric group.

Few studies exist examining interferon use in children with chronic HCV, however a recent study in Hepatology suggests that interferon therapy may be beneficial The rates of initial and long-lasting response were higher in the study than those observed in adults treated with standard schedules. Possible explanations include the shorter time of infection in children, and that most have a mild form of liver disease. The results of this study are encouraging, according to the researchers, but more investigation needs to be conducted.

Many questions still remain about chronic hepatitis C in children.

Further studies need to be done to determine the disease’s course and progress as well as the role of interferon treatment. (Leslie Gibbenhuck, President, Children’s Liver Alliance, Canada bchepc@telus.net)



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