Abstract # THU-286 Chronic hepatitis C in children in the Russian Federation: a multicenter study–G.V. Volynets et. al.
Study Aims and Results: The burden of paediatric HCV infection in Europe is not well described. Our aim
was to provide a detailed characterization of children with chronic HCV in 3 paediatric hepatology
centres in the Russian Federation. A multi-site cross-sectional study of children and adolescents
aged <19 years with chronic HCV infection followed-up in 3 centres in Russia (Moscow, St Petersburg, Krasnoyarsk) was
conducted in November 2014 to July 2015.
The 301 children (48% female) had a median age of 10.6 years (IQR, 7.2,14.6); most (281,
93%)were of white ethnicity. Most children were vertically infected (194, 64%); other routes
were contaminated blood products (38,13%), nosocomial infection (31, 10%), injecting drug use
(1), and unknown (37, 12%). Median age at HCV diagnosis was 3.1 years (IQR, 1.1, 15.1). Six
children were HIV-co-infected; 1 child was HBsAg positive. Genotypes were 1a: 10 (3%); 1b: 155
(51%); 3: 111 (37%); unknown: 10 (3%). Elevated ALTand AST (>40 IU/L) were present in 82
(27%) and 88 (29%) respectively at the last visit. 89 (30%) children had liver biopsies evaluated
by Knodell or METAVIR scoring systems. Fibrosis stage was significantly associated with
inflammation (p < 0.01) but not with age, genotype, mode of infection, or duration of infection
(among vertically infected). Of 223 childrwith transient elastography (TE) results, 188 (84%) had
no (<5.8 kPa), 28 (13%) minimal (5.8–7.1 kPa), 6 (3%) moderate (7.2–9.4 kPa) and 1 severe
fibrosis (9.5–12.5 kPa). Of 250 children with fibrosis assessed by TE and/or biopsy, 41 (16%) had
significant fibrosis (>7.2 kPa/F2).
Based on ultrasound scans, 19/170 (6%) children had steatosis and 19 (6%) had signs of portal
hypertension. Overall, 67% of children (n =203) had been treated or were on treatment (Table).
Of those with HCV results 24 weeks post treatment discontinuation, 55% (101/182) had SVR24;
in those treated with PeglFN/ribavirin, 66% (69/104) had SVR24 (35 with GT1 and 34 with GT3).
Conclusions: The described paediatric chronic HCV cohorts in Russia have considerable
proportions of treatment experienced children (67%) and children with significant fibrosis
(16%). With currently licensed treatment, the rate of side effects was substantial, although
the reaction to drugs led to treatment discontinuation only in few children. The study highlights
the need to treat children early to prevent progression of liver disease with more effective and
better tolerated treatment.Share This Page