New prospects for the treatment and prevention of hepatitis C in children.
New prospects for the treatment and prevention of hepatitis C in children.
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DOI：
10.1097/mop.0000000000000313
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发表时间：
2016-02
影响因子：
3.6
通讯作者：
Honegger J
中科院分区：
文献类型：
--
作者：
Ohmer S;Honegger J
Combined pegylated interferon-α and ribavirin remain the standard therapy for pediatric hepatitis C virus (HCV) infection in 2016, but direct acting antivirals (DAAs) with greatly improved efficacy and safety are now approved for adults. Here we review the major classes of DAAs and their anticipated use for treatment and potentially prevention of HCV in children. Currently approved DAAs target the viral protease, polymerase, and NS5A, a protein involved in viral replication and assembly. In combination, they have lifted sustained virologic response rates to over 90% for multiple HCV genotypes, and the rich DAA pipeline promises further improvements. Clinical trials of interferon-free DAA regimens have been initiated for children ages 3–17 years. The first efficacy trial of a preventative HCV vaccine for adults is also underway. While awaiting a vaccine, there is hope that increased DAA uptake may prevent pediatric HCV infections by shrinking the pool of infectious persons. Interferon-free DAA regimens have revolutionized therapy for HCV-infected adults and pending results of pediatric trials will likely do the same for HCV-infected children. If widely deployed, particularly amongst individuals likely to transmit HCV, DAA therapies may also help reduce new vertically- and horizontally-acquired pediatric infections.
