Abstract
Hepatitis C is a global public health threat. The introduction of direct-acting antivirals
(DAAs) brings the prospect of curing the 71 million people living with the disease,
dramatically changing the landscape of hepatitis C. The World Health Organization
developed a roadmap for the elimination and cure of hepatitis C by 2030 with a clear
goal with measurable targets. However, there is a lack of a well-defined strategy
to tackle the hepatitis C virus (HCV) problem in children and adolescents vis-à-vis
the adult population. Hepatitis C in children and adolescents can be addressed as
part of a national policy for elimination in the whole population, namely macroelimination,
or could be fragmented into a microelimination approach targeting the high-risk population
groups. Children born to HCV-infected mothers, adolescents who are injecting drugs,
migrants, and those suffering from inherited blood diseases are important target populations.
After the U.S. Food and Drug Administration approval for the use of DAAs in children
aged 3 years and above, evidence from clinical trials and real-world experience was
accumulated using brand and generic medicines, with sustained virological response
rates exceeding 95%. The evidence created should guide policies on the management
of hepatitis C in children and adolescents. There are many challenges in managing
HCV in this left-behind marginalized population. The lack of awareness and epidemiological
data, consent age, prohibitive prices of medicines, and absence of policies on access
to diagnostics, treatment, and linkage to care are among the many barriers to service
delivery that should be addressed to achieve the elimination goal by 2030.
Keywords
elimination of HCV - chronic hepatitis C - children and adolescents - direct-acting
antivirals
