https://www.ncbi.nlm.nih.gov/pubmed/32205770 Hepatitis C

J Pediatr Gastroenterol Nutr. 2020 Mar 20. doi: 10.1097/MPG.0000000000002710. [Epub ahead of print]
Comparison of Recommendations for Treatment of Chronic Hepatitis C Virus Infection in Children and Adolescents: A Position Paper of the Global Federation of International Societies of International Societies of Pediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN).
Indolfi G1, Fischler B2, Gonzalez-Peralta RP3, Ciocca M4, Porta G5, Neelam M6, Guindi ME7, Kelly D8, Ni YH9, Sibal A10, Leung DH11, Chang MH12; Hepatitis Expert Team of the Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN).

Abstract

OBJECTIVE:
This position paper written by the Hepatitis Expert Team of the Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition aimed to systematically evaluate clinical practice guidelines (CPGs), medical consensus and position papers on the use of direct-acting antivirals (DAA) to treat chronic hepatitis C virus (HCV) infection in adolescents and children in order to compare recommendations and provide the basis for developing a unified position statement.

METHODS:
MEDLINE, Cochrane-Library, National Guideline Clearinghouse and select websites of relevant societies/organizations were used to identify CPGs, medical consensus and position papers between 2011-2019.

RESULTS:
A total of five documents were analysed: three CPGs, one medical consensus and one position paper. All publications were consistent in recommending DAA treatment for adolescents (12-17 years-old) with chronic HCV infection. Similarly, all of these publications consistently recommended deferring therapy for children between 3 and 11 years of age until DAA became available as standard of care. Finally, none of the included publications recommended treating children younger than 3 years old. By contrast, there was significant discrepancy across the retrieved documents regarding specific DAA regimens and treatment strategies.

CONCLUSIONS:
There is strong consensus on treating all adolescents with chronic HCV infection with DAA and on delaying therapy in younger children until these agents are approved for them. Interferon-based therapies should be avoided. Specific recommendations regarding which DAA regimen to use and treatment duration varied significantly. Key stakeholders need to convene to standardize therapeutic strategies at a global level if we are to eradicate HCV in children