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Boletín Médico del Hospital Infantil de México

2009, Número 2

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Bol Med Hosp Infant Mex 2009; 66 (2)


Hepatitis C en población pediátrica: panorama actual

Heller-Rouassant S, Valencia-Mayoral P

Idioma: Español
Referencias bibliográficas: 184
Paginas: 189-203
Archivo PDF: 250.14 Kb.


RESUMEN

La hepatitis C (HC) es una causa importante de enfermedad hepática crónica a nivel mundial. El virus de la HC tiene una diversidad genética compleja, con seis genotipos, de los cuales el genotipo 1 es el más frecuente, seguido del 2 y el 3. La vía de transmisión más frecuente de la infección en niños actualmente es la perinatal. La HC crónica (HCC) es generalmente silenciosa, frecuentemente con aminotransferasas séricas elevadas. El diagnóstico de HCC se puede sospechar por datos clínicos y alteraciones bioquímicas, y confirmarse con estudios serológicos de anticuerpos anti HC, estudios de biología molecular que detectan cualitativa y cuantitativamente viremia, la presencia de alteraciones histológicas hepáticas de inflamación, esteatosis, fibrosis y cirrosis, y biomarcadores séricos de fibrosis e inflamación hepática que pueden ofrecer un arma diagnóstica no invasora. La mejor opción terapéutica actual de tratamiento para HCC es el uso prolongado combinado de interferón pegilado y ribavirina, que se ha asociado a un porcentaje de respuesta viral sostenida más elevado que con la monoterapia con interferón alfa. La principal medida de prevención de HC es un control estricto de las transfusiones sanguíneas, lo que ha reducido su incidencia; además de los trabajos en el desarrollo de vacunas de HC, que podrán tener un papel preventivo y terapéutico en el control de la infección por virus de HC.


REFERENCIAS (EN ESTE ARTÍCULO)

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  101. Ishii T, Ohto H, Takeuchi C, Ariga H, Hirai S, Ujiie N, et al. Evolution in the hypervariable region of the hepatitis C virus in two infants infected by mother -to -infant transmission. Pediatr Int. 2005; 47: 278-85.

  102. Matsubara T, Sumazaki R, Shin K, Nagai Y, Takita H. Genotyping of hepatitis C virus: Coinfections by multiple genotypes detected in children with chronic post transfusion hepatitis C. J Pediatr Gastroenterol Nutr. 1996; 22: 79-84.

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  104. Cital-Zamora JL, Navarrete-Castro R, Magaña-Muñoz KD, Martínez-Rodríguez MA, Calderón GM. Prevalence of hepatitis C virus genotypes in a Mexican population. Arch Med Res. 2005; 36: 607.

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  108. García-Montalvo BM, Galguera-Colorado PL. Distribution of hepatitis C virus genotypes, risk factors and liver disease in patients from Yucatan, Mexico. Ann Hepatol. 2008: 7: 345-9.

  109. Donahue JG, Muñoz A, Ness PM, Brown DE Jr, Yawn DH, McAllister HA Jr, et al. The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med. 1992; 327: 369-73.

  110. Bortolotti F, Resti M, Giacchino R, Crivellaro C, Zancan L, Azzari C, et al. Changing epidemiologic pattern of chronic hepatitis C virus infection in Italian children. J Pediatr. 1998; 133: 378-81.

  111. Davison CM, Mieli-Cergani G, SIra J, Kelly DA. Perinatal hepatitis C virus infection: Diagnosis and management. Arch Dis Child. 2006; 91: 781-5.

  112. Mok J, Pembrey L, Toyo PA, Newell ML. When does mother to child transmission of hepatitis C virus occur? Arch Dis Fetal Neonatal Ed. 2005; 90: F156-60.

  113. Granovsky MO, Minkoff HL, Tess BH, Waters D, Hatzakis A, Devoid DE, et al. Hepatitis C virus infection in the mothers and infants cohort study. Pediatrics. 1998; 102: 355-9.

  114. Schuval S, van Dyke RB, Lindsey JC. Hepatitis C prevalence in children with perinatal human immunodeficiency virus infection enrolled in a log-term follow-up protocol. Arch Pediatr Adolesc Med. 2004; 158: 1007-13.

  115. Kuman RM, Shabul S. Role of breast-feeding in transmission of hepatitis C virus to infants of HCV-infected mothers. J Hepatol. 1998; 29: 191-7.

  116. Pembrey l, Newell ML, Tovo PA, EPHN Collaborators. The management of HCV infected pregnant women and their children. European paediatric HCV network. J Hepatol. 2005; 43: 515-25.

  117. England K, Pembrey L, Tovo PA. Excluding hepatitis C virus (HCV) infection by serology in young infants of HCV-infected mothers. Acta Paediatr. 2005; 94: 44-50.

  118. Szabo G, Dolganiuc A. Hepatitis C and innate immunity: Recent advances. Clin Liver Dis. 2008; 12: 675-92.

  119. Narkewicz MR, Cabrera R, González-Peralta RP. The “C” of viral hepatitis in children. Semin Liver Dis. 2007; 27: 295-311.

  120. Vrielink H, Reesink HW, van der Burg PJ, Zaaijer HL, Cuypers HT, Lelie PN, et al. Performance of three generations of anti-hepatitis C virus enzyme linked immunosorbant assay in donors and patients. Transfusion. 1997; 37: 745-9.

  121. Gretch DR. Diagnostic test for hepatitis C. Hepatology. 1997; 26 Suppl 1: 43-7.

  122. Esteban JI, González A, Hernández JM, Viladomiu L, Sánchez C, López-Talavera JC, et al. Evaluation of antibodies to hepatitis C virus in a study of transfusion-associated hepatitis. N Engl J Med. 1990; 323: 1107-12.

  123. Pawlotsky JM, Bouvier-Alias M, Hezode C, Darthuy F, Remire J, Dhumeaux D. Standardization of hepatitis C virus RNA quantification. Hepatology. 2000; 32: 654-9.

  124. Gretch DR, de la Rosa C, Carithers RL Jr, Willson RA, Williams B, Corey L. Assessment of hepatitis C viremia using molecular amplification technologies: Correlations and clinical implications. Ann Intern Med. 1995; 123: 321-9.

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