Advanced liver disease in Russian children and adolescents with chronic hepatitis C

• DOI: 10.1111/jvh.13093
• Publication Date: 2019-02-26T06:29:04Z
• Authors: Anna Turkova; Galina V. Volynets; Siobhan Crichton; Tamara A. Skvortsova; Victoria N. Panfi...; Natalia V. Rogozina; Anatoly I. Khavkin; Elena L. Tumanova; Giuseppe Indolfi; Claire Thorne
• Keywords: Transient elastography; Interquartile range; Liver disease; Hepatitis C; Discontinuation

Russia has one of the highest prevalences paediatric chronic hepatitis C infection (CHC). Our aim was to provide a detailed characterization children and adolescents with CHC including treatment outcomes. Thus, an observational study aged <18 years conducted in three hepatology centres from November 2014 May 2017. Of 301 (52% male), 196 (65%) acquired HCV vertically, 70 (23%) had history blood transfusion or invasive procedures, 1 injecting drug use 34 (11%) no known risk factors. Median age at diagnosis 3.1 [interquartile range, IQR 1.1, 8.2] 10.8 [7.4, 14.7] last follow-up. The most common genotype 1b (51%), followed by 3 (37%). Over quarter patients (84, 28%) raised liver transaminases. 92 biopsy, 38 (41%) bridging fibrosis (median 10.4 [7.1, 14.1]). 223 evaluated transient elastography, 67 (30%) stiffness ≥5.0 kPa. For each year, increase mean increased 0.09 kPa (95% CI 0.05, 0.13, P < 0.001). There significant correlation between biopsy results (Tau-b = 0.29, 0.042). 205 treated IFN-based regimens, 100 (49%) SVR24. Most (191, 93%) experienced adverse reactions, leading discontinuation 6 (3%). In conclusion, third via nonvertical routes substantial proportion those advanced disease. Only half achieved SVR24 regimens highlighting need for more effective better-tolerated treatments direct-acting antivirals. Further studies are warranted on causes prevention transmission children.