Focus on children with viral hepatitis imperative for elimination goals

Recent data revealed that, worldwide, 52 million children are living with viral hepatitis, compared with 2.1 million children with HIV or AIDS, according to data presented at the World Hepatitis Summit 2017 in São Paulo, Brazil.

“We must act and treat as many children as possible. The economic and social benefit of early hepatitis C treatment in children is substantial,” Manal El-Sayed, MD, professor of pediatrics at Ain Shams University, Cairo, Egypt, said in a related press release. “This includes avoiding disease progression, removing social stigma and improving activity and school performance, and reducing fatigue. However, the fundamental principle is to avoid transmission by adopting ‘cure as prevention’ at an early age and before high risk behaviors emerge that enable transmission.”

El-Sayed and colleagues report that 4 million children younger than 19 years have hepatitis C and 48 million children younger than 18 years have hepatitis B. Additionally, 21 countries account for 80% of children with HCV, including Pakistan, China, Nigeria, Egypt, Russia, Syria, Indonesia and Bangladesh.

While the U.S. FDA and the European Medicines Agency approved certain direct-acting antivirals for children aged 12 years and older, the researchers stated that there has not been much evidence of their use in high-income countries and the WHO has not yet recommended DAA use in children of any age.

HBV infection rates have declined from a prevalence rate of 4.7% in the pre-vaccination era of the early 1980’s to 1.3% after improved efforts to prevent mother-to-child transmission and an increase to 84% of countries that offer HBV vaccinations. Coverage of initial birth dose vaccination remains lower at 39%.

El-Sayed and colleagues expect the rates of HCV infections in children to increase in the years to come as there are a lack of prevention and control programs for pregnant women and women of child-bearing age with HCV.

“Children are the future,” Raquel Peck, CEO of World Hepatitis Alliance, said in the press release. “It’s imperative that we get it right from the beginning and give them the best possible start in life. Without eliminating viral hepatitis amongst children, its elimination will be impossible.” – by Talitha Bennett

Reference:

El-Sayed M, et al. Towards elimination of HCV in children: clinical and treatment perspective. Presented at: The World Hepatitis Summit 2017; Nov. 1-3, 2017; São Paulo, Brazil.

Disclosure: Healio.com/Hepatology was unable to determine relevant financial disclosures at the time of publication.