儿童丙型肝炎的自然史和管理:意大利北部一家参考中心 25 年的经验。

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Pediatric Infectious Disease Journal Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI:10.1097/INF.0000000000004374
Francesca Musto, Marta Stracuzzi, Elisa Crivellaro, Valeria Rubinacci, Alessandro Cibarelli, Cecilia Porro, Elena Ghidoni, Gian Vincenzo Zuccotti, Vania Giacomet
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引用次数: 0

摘要

儿科丙型肝炎病毒(HCV)感染的自然史和管理仍存在争议。我们回顾性评估了 1997 年 1 月至 2022 年 1 月期间(中位随访 10 年)在路易吉-萨科医院(意大利米兰)儿科传染病部接受治疗的丙型肝炎病毒儿科患者的疗效,并重点关注了新药和瞬态弹性成像的作用。我们共招募了 57 名患者:其中 8 人(14%)自发清除,33 人接受了治疗(58%),7 人(12%)因未满 12 岁而未接受治疗,9 人在随访中死亡。所有接受治疗的患者在治疗结束时、12 周后(SVR12)和后续随访期间均检测不到 HCV RNA。所有接受治疗的患者都在治疗前和治疗后一年接受了弹性成像检查。治疗前的中位硬度为 5.6 kPa,9 名患者(16%)的瞬时弹性成像异常(>7 kPa,中位值为 8.7 kPa)。异常组治疗后的中位硬度为 6.8 kPa。直接作用抗病毒药物是治疗儿童慢性丙型肝炎病毒感染的一种安全有效的方法。许多 12 岁前垂直感染的儿童肝脏弹性成像正常,但当出现异常时,直接作用抗病毒药物治疗后会有明显改善。需要进一步研究评估弹性成像在儿童诊断和随访中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Natural History and Management of Hepatitis C in Children: 25 Years Experience of a Reference Center in Northern Italy.

Hepatitis C virus (HCV) infection natural history and management in the pediatric population are still debated. We retrospectively evaluated the outcome of a HCV pediatric population managed at the Pediatric Infectious Disease Unit of Luigi Sacco Hospital (Milan, Italy) from January 1997 to January 2022 (median follow-up 10 years) and we focused on the role of new drugs and transient elastography. Fifty-seven patients were enrolled: 8 (14%) had a spontaneous clearance, 33 were treated (58%), 7 (12%) were not treated because they were under 12 years old and 9 were lost at follow-up. HCV RNA was undetectable in all treated patients at the end of therapy, after 12 weeks (SVR12) and for the rest of their follow-up. All patients treated underwent elastography before and 1 year after therapy. Median stiffness pretherapy was 5.6 kPa, and 9 patients (16%) had abnormal transient elastography (>7 kPa, median 8.7 kPa). Median stiffness after treatment in the abnormal group was 6.8 kPa. Direct-acting antiviral agents are a safe and effective therapy for HCV chronic infection in the pediatric population. Liver elastography is normal in many vertically infected children before 12 years, but, when abnormal, it shows a significant improvement after direct-acting antiviral agent treatment. Further studies are needed to evaluate the role of elastography at diagnosis and follow-up in children.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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