Today’s post on Hepatitis C follows a few screenshots from twitter regarding the coronavirus epidemic.
Pediatric report of coronavirus in children: NEJM Full link: SARS-CoV-2 Infection in Children A recent review of 72,314 cases by the Chinese Center for Disease Control and Prevention showed that less than 1% of the cases were in children younger than 10 years of age (n=171)…3 patients required intensive care support and invasive mechanical ventilation; all had coexisting conditions. There was one death in a 10-month-old child with intussusception had multiorgan failure and died 4 weeks after admission.
As noted yesterday, this post will review a recent practice guidance for hepatitis C
- AASLD-IDSA Practice Guidance Panel. Hepatology 2020; 71: 686-721
- Here’s a link to full report: HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
Some specific recommendations for children:
- “All children born to HCV-infected women should be tested for HCV infection. Testing is recommended using an antibody-based test at or after 18 months of age.”
- “Testing with an HCV-RNA assay can be considered in the first year of life, but the optimal timing of such testing is unknown” (but can be done as early as 2 months of life).
- “The siblings of children with vertically-acquired chronic HCV should be tested for HCV infection, if born from the same mother.”
Counseling for parents:
- “Parents should be informed that hepatitis C is not transmitted by casual contact and, as such, children with HCV infection do not pose a risk to other children and can participate in school, sports, and athletic activities, and engage in all other regular childhood activities without restrictions.”
- “Parents should be informed that universal precautions should be followed at school and in the home of children with HCV infection. Educate families and children about the risk and routes of HCV transmission, and the techniques for avoiding blood exposure, such as avoiding the sharing of toothbrushes, razors, and nail clippers, and the use of gloves and dilute bleach to clean up blood.”
- “Direct-acting antiviral (DAA) treatment with an approved regimen is recommended for all children and adolescents with HCV infection aged ≥3 years as they will benefit from antiviral therapy, regardless of disease severity.”
- Early treatment in childhood is expected to be cost-effective compared to treatment at later ages based on previous studies