Aa
Small Child with HepC
Hi....I was qondering if there is anyone out there with a small child with HepC. I have a 2y/o boy that we had tested when he was 5months old and he was positive (they tested for the virus not the antibodies since his biomom was positive). We had to wait till he was 2 to have him retested to see if he cleared the virus on his own. He did not and they told us he does have chronic HepC. We are awaiting the results on his genotyping and aditional blood tests that they ran but they did get the results that his iron was low and had us start him on vitamins with iron. I have searched many places and cannot find out much info on very small children with HepC...anyone have any info or know where I can find more?
thanks!
tiggs
thanks!
tiggs
Thank you everyone for your responses! Our little guy is being seen by a pediactric GI dr at one of the best childrens hospitals in the country...we have an apt coming up next week to go over all his lab tests genotyping etc...and discuss any further tests and a game plan. We have been struggling with the decision about treatment sooner that later. both have thier up and down sides,
Thank you for the link to Elijah's story. I will definatly read on that board as soon as I get acces LOL. Looks like our stories are errily similar...we adopted our little guy and have had him since birth and knew his mom was pos...we also named our little guy Eli :-)
Thank you for the link to Elijah's story. I will definatly read on that board as soon as I get acces LOL. Looks like our stories are errily similar...we adopted our little guy and have had him since birth and knew his mom was pos...we also named our little guy Eli :-)
Aaron thank you for sharing the story about little Elijah, what a wonderful story! If a child of 5 can do the treatment and come through, I believe I will have to cowboy up and slay my dragon as well...anne
Hi TM, Welcome to the forum .. so very sorry to hear about your child's challenge.
On a different forum, Nomads, there is a young boy "Elijah", now 6yrs. who completed Tx at Wk. 69 of a planned 72 wks Tx ..
The family is still waiting for the 6 month EOT PCR , they don't know yet know the Tx outcome ...
Perhaps you might want to read about his Tx story there ... there are many posts ..
hepcnomads.co.uk/phpBB3/index.php
I'm putting in a link to a article that was written about Elijah last X-mas .. it is very heartwarming & shows the care and concern folks in this hcv community have ..
http://fayobserver.com/articles/2010/12/19/1056486
All the Best , Aaron
On a different forum, Nomads, there is a young boy "Elijah", now 6yrs. who completed Tx at Wk. 69 of a planned 72 wks Tx ..
The family is still waiting for the 6 month EOT PCR , they don't know yet know the Tx outcome ...
Perhaps you might want to read about his Tx story there ... there are many posts ..
hepcnomads.co.uk/phpBB3/index.php
I'm putting in a link to a article that was written about Elijah last X-mas .. it is very heartwarming & shows the care and concern folks in this hcv community have ..
http://fayobserver.com/articles/2010/12/19/1056486
All the Best , Aaron
the first post is from 2004 this one is 2008
The approval of PegIntron for the pediatric indication is based on the results of a clinical trial in 107 previously untreated patients 3 to 17 years of age with chronic hepatitis C and compensated liver disease. In the study, patients infected with HCV genotype 1 or 4 and those with HCV genotype 3 with HCV RNA greater than 600,000 IU/mL (high viral load [HVL]) were assigned 48 weeks of therapy, while those infected with HCV genotype 2 or 3 with HCV RNA less than 600,000 IU/mL (low viral load [LVL]) received 24 weeks of therapy. Of the patients with HCV genotype 1, 4 or 3 HVL who were assigned to 48 weeks of treatment, 55 percent achieved SVR. As with adult patients, SVR in pediatric patients with HCV genotype 2 or 3 LVL was much higher than in those with genotype 1; the SVR rate was 96 percent in children with HCV genotype 2 or 3 LVL.
In the pediatric population, the recommended dose of PegIntron, based on body surface area, is 60 mcg/m2/week subcutaneously in combination with 15 mg/kg/day of Rebetol, based on body weight, orally in two divided doses. The treatment duration for patients with HCV genotype 1 is 48 weeks and for patients with HCV genotype 2 or 3 it is 24 weeks. Patients receiving PegIntron combination therapy (excluding those with HCV genotype 2 or 3) should be discontinued from therapy at week 12 if their HCV RNA dropped less than 2 log10 compared to pretreatment or at 24 weeks if they have detectable HCV RNA at treatment week 24.
During the course of therapy lasting up to 48 weeks in patients 3 to 17 years of age, weight loss and growth inhibition were common. Some children who experienced growth inhibition during therapy still had inhibited growth velocity 6 months following the end of treatment. Most common adverse reactions (more than 25 percent) observed in these studies were pyrexia, headache, neutropenia, fatigue, anorexia, injection site erythema and vomiting. Three percent were treated for clinical hypothyroidism.
Dose modifications were required in 25 percent of patients, most commonly for anemia, neutropenia and weight loss. Therapy was discontinued prematurely in two percent of the patients
The approval of PegIntron for the pediatric indication is based on the results of a clinical trial in 107 previously untreated patients 3 to 17 years of age with chronic hepatitis C and compensated liver disease. In the study, patients infected with HCV genotype 1 or 4 and those with HCV genotype 3 with HCV RNA greater than 600,000 IU/mL (high viral load [HVL]) were assigned 48 weeks of therapy, while those infected with HCV genotype 2 or 3 with HCV RNA less than 600,000 IU/mL (low viral load [LVL]) received 24 weeks of therapy. Of the patients with HCV genotype 1, 4 or 3 HVL who were assigned to 48 weeks of treatment, 55 percent achieved SVR. As with adult patients, SVR in pediatric patients with HCV genotype 2 or 3 LVL was much higher than in those with genotype 1; the SVR rate was 96 percent in children with HCV genotype 2 or 3 LVL.
In the pediatric population, the recommended dose of PegIntron, based on body surface area, is 60 mcg/m2/week subcutaneously in combination with 15 mg/kg/day of Rebetol, based on body weight, orally in two divided doses. The treatment duration for patients with HCV genotype 1 is 48 weeks and for patients with HCV genotype 2 or 3 it is 24 weeks. Patients receiving PegIntron combination therapy (excluding those with HCV genotype 2 or 3) should be discontinued from therapy at week 12 if their HCV RNA dropped less than 2 log10 compared to pretreatment or at 24 weeks if they have detectable HCV RNA at treatment week 24.
During the course of therapy lasting up to 48 weeks in patients 3 to 17 years of age, weight loss and growth inhibition were common. Some children who experienced growth inhibition during therapy still had inhibited growth velocity 6 months following the end of treatment. Most common adverse reactions (more than 25 percent) observed in these studies were pyrexia, headache, neutropenia, fatigue, anorexia, injection site erythema and vomiting. Three percent were treated for clinical hypothyroidism.
Dose modifications were required in 25 percent of patients, most commonly for anemia, neutropenia and weight loss. Therapy was discontinued prematurely in two percent of the patients
The possible roads the physician must decide to take in managing the child with chronic hepatitis C virus (HCV) infection are not nearly as well-marked as are the adult treatment highways. Divergences include decisions about whether or not to treat, when to treat, and with what agent or agents. One of the main dilemmas is that the "bends in the undergrowth"—long-term consequences of both the infection and currently available therapies—are not well mapped.
Children with chronic HCV infection are certainly at some increased risk for the serious lifetime liver disease attributable to the virus, including cirrhosis, end-stage liver disease requiring liver transplantation, and liver cancer. While the disease is generally clinically mild in childhood, it most definitely brings suffering, because of anxiety about the future as well as the palpable social stigma. For these reasons, serious attention to treatment of pediatric HCV is warranted and long overdue for the estimated 100,000 to 150,000 infected children in the US alone, and for an unknown number worldwide.[1] Furthermore, there are approximately 50,000 new cases of maternal-fetal transmission of HCV worldwide annually.[2] Thus, there is clearly a need for better roadmaps.
Until this year, there had been no FDA-approved treatment for children with HCV infection. Previous reports of interferon monotherapy for children suggested that sustained virologic responses (SVRs) for children with genotype 1 (27%) were around 3-fold better than those reported for adults.[3] Even better, the SVR for children with genotype non-1 infection was as high as 70%. The superior response of children to interferon-based therapy is biologically plausible, because in general children have lower viral loads, precirrhotic liver disease, and a shorter duration of infection, all of which characterize adults who respond to interferon treatment.
Recently, the combination of interferon thrice weekly and daily oral ribavirin was approved by the FDA for the treatment of HCV-infected children. When given interferon alfa 3 MU/m2 SQ TIW and ribavirin 15 mg/kg/day in 2 divided doses for 48 weeks, 45% of children achieved an SVR, including 38% for those with genotype 1.[4,5] In general, the treatment was well-tolerated. Side effects included hemolytic anemia and flu-like side effects.
There are preliminary data on the use of pegylated interferon in children with chronic HCV infection, in which SVR rates of 40-50% were reported.[6] The drug was generally well-tolerated, except for neutropenia, which necessitated dose reduction in a portion of patients. To date, there are no published reports of pegylated interferon plus ribavirin in children. Since ribavirin is a teratogen, and since children with HCV exhibit better responses to interferon-based therapies than do adults, there is concern about the dangers of administering this drug to adolescent females of child-bearing age before controlled trials have demonstrated the need.
A new multicenter trial (PEDS-C) has just been started to investigate the safety and efficacy of pegylated interferon with or without ribavirin for the treatment of HCV infection in children. This 5-year study will also focus on the effects of these treatments on body composition and growth, neurocognitive function, and health-related quality of life. Hopefully, such a comprehensive effort will lead to more legible signposts for the physician caring for a child with this all-too-common and potentially life-threatening infection.
Children with chronic HCV infection are certainly at some increased risk for the serious lifetime liver disease attributable to the virus, including cirrhosis, end-stage liver disease requiring liver transplantation, and liver cancer. While the disease is generally clinically mild in childhood, it most definitely brings suffering, because of anxiety about the future as well as the palpable social stigma. For these reasons, serious attention to treatment of pediatric HCV is warranted and long overdue for the estimated 100,000 to 150,000 infected children in the US alone, and for an unknown number worldwide.[1] Furthermore, there are approximately 50,000 new cases of maternal-fetal transmission of HCV worldwide annually.[2] Thus, there is clearly a need for better roadmaps.
Until this year, there had been no FDA-approved treatment for children with HCV infection. Previous reports of interferon monotherapy for children suggested that sustained virologic responses (SVRs) for children with genotype 1 (27%) were around 3-fold better than those reported for adults.[3] Even better, the SVR for children with genotype non-1 infection was as high as 70%. The superior response of children to interferon-based therapy is biologically plausible, because in general children have lower viral loads, precirrhotic liver disease, and a shorter duration of infection, all of which characterize adults who respond to interferon treatment.
Recently, the combination of interferon thrice weekly and daily oral ribavirin was approved by the FDA for the treatment of HCV-infected children. When given interferon alfa 3 MU/m2 SQ TIW and ribavirin 15 mg/kg/day in 2 divided doses for 48 weeks, 45% of children achieved an SVR, including 38% for those with genotype 1.[4,5] In general, the treatment was well-tolerated. Side effects included hemolytic anemia and flu-like side effects.
There are preliminary data on the use of pegylated interferon in children with chronic HCV infection, in which SVR rates of 40-50% were reported.[6] The drug was generally well-tolerated, except for neutropenia, which necessitated dose reduction in a portion of patients. To date, there are no published reports of pegylated interferon plus ribavirin in children. Since ribavirin is a teratogen, and since children with HCV exhibit better responses to interferon-based therapies than do adults, there is concern about the dangers of administering this drug to adolescent females of child-bearing age before controlled trials have demonstrated the need.
A new multicenter trial (PEDS-C) has just been started to investigate the safety and efficacy of pegylated interferon with or without ribavirin for the treatment of HCV infection in children. This 5-year study will also focus on the effects of these treatments on body composition and growth, neurocognitive function, and health-related quality of life. Hopefully, such a comprehensive effort will lead to more legible signposts for the physician caring for a child with this all-too-common and potentially life-threatening infection.
Hi there....I would just like to say that I am sorry about your little ones diagnosis. and that he didn"t clear the virus on his own. I do not have any experience with having a child myself with HCV .however I would just like to welcome you to the forum and I do believe there is a couple of folks here that have had children that tested positive.
If not already, I would suggest he be under the care of a knowledgeable paediatric hepatologist. to monitor his condition and possibly discuss treatment options in the future.
From what I understand young children that have either geno type 2 or 3 do very well when treating with almost a 80 - 90 % success rate and that all children who treat as a whole do better in general than adults as their immune systems are stronger and usually tend to tolerate the medication better.
Again..... possibly someone will chime in who has a child that has tested positive and / or their child has treated.
Best to you and your little one
Will
..
If not already, I would suggest he be under the care of a knowledgeable paediatric hepatologist. to monitor his condition and possibly discuss treatment options in the future.
From what I understand young children that have either geno type 2 or 3 do very well when treating with almost a 80 - 90 % success rate and that all children who treat as a whole do better in general than adults as their immune systems are stronger and usually tend to tolerate the medication better.
Again..... possibly someone will chime in who has a child that has tested positive and / or their child has treated.
Best to you and your little one
Will
..
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