Abstract

Background: Viral hepatitis is a leading cause of liver disease in children, primarily caused by hepatitis A, B, and C viruses.1,2 Since 2022, there has been a rising number of pediatric hepatitis cases with unclear origins, indicating the potential emergence of new etiologies.3 This study aimed to analyze the increasing trends of viral hepatitis in children, with a particular focus on hepatitis C. It included data from a regional hospital registry in Dnipro, Ukraine, that documented 167 children diagnosed with viral hepatitis C and B, highlighting the challenges of diagnosis and treatment. Additionally, the study presents illustrative cases to demonstrate clinical variability and systemic barriers, offering a comprehensive overview of the issue.4,5 Methods: A retrospective analysis of clinical and laboratory data from 167 children aged 2–18 years with viral hepatitis was conducted. Barriers to care, treatment outcomes, and the utility of direct-acting antiviral (DAA) therapies were assessed. Three illustrative cases were presented to highlight the diverse clinical challenges and outcomes.6 Results: In a study of 167 children, 86% were diagnosed with chronic hepatitis C (CHC), and 14% with chronic hepatitis B (CHBV). Of the 106 treated for CHC with direct-acting antiviral agents (DAA), 105 achieved a sustained virologic response (SVR) within 12 weeks. All 16 patients treated for CHBV, using pegylated interferons, entecavir, or lamivudine, reached undetectable DNA levels or significant viral load reductions, with normalized ALT and AST levels. Barriers to care included low public awareness, high diagnostic costs, and logistical delays. Three case studies highlight challenges such as severe acute hepatitis, chronic infections, and unknown causes.7,8 Conclusion: Addressing gaps in awareness, diagnostic processes, and access to pediatric-appropriate medications is critical for improving outcomes in pediatric hepatitis. Continued research is needed to address the rising burden of acute hepatitis cases of unknown etiology.9,10

Keywords

viral hepatitis C, children, pediatric formulations, velpatasvir, public health, adenoviruses