Cosa deve sapere oggi il pediatra del trattamento dell’epatite C nell’era dei nuovi farmaci antivirali?

The treatment of hepatitis C virus (HCV) infection with the new directacting antivirals (DAAs) has dramatically modified the natural history of the HCV-related disease, eradicating the virus in over 90% of treated patients, with negligible collateral effects. The high costs of treatment, however, represent a factor that limits patients’ access to therapy and burdens the countries’ healthcare systems. In Italy the estimated cost of treatment for a naïve patient (8/12 weeks) amounts to approximately €5,500 (VAT excluded). HCV liver disease especially affects adults, in Italy the average prevalence of hepatitis C ranges between 2.4% and 3.3% in the general population. The prevalence of hepatitis C in children is significantly lower (0.15%) and the liver disease is rarely progressive in the paediatric age; however, there are not tools capable of interrupting the main route of infection, namely the vertical transmission from the infected mother. The effectiveness and great manageability of these new direct antivirals have also allowed their use in paediatrics starting from three years of age.