Low hepatitis C treatment rates reported in children

Low hepatitis C treatment rates reported in children | Image Credit: © jarun011 – © jarun011 – stock.adobe.com.

Access to hepatitis C virus (HCV) is low in children, according to a recent study published in Pediatrics.

Data has indicated a rise of pediatric HCV cases in the United States. While guidelines recommend treatment for HCV begin in children aged as young as 3 years, research has not been conducted on a national level to link HCV care and direct-acting antiviral (DAA) uptake in children.

“This study aims to characterize the HCV care cascade among a national cohort of children with HCV,” wrote investigators.

Low Linkage and treatment

Children born from 2000 to 2018 and diagnosed with HCV while aged 0 to 18 years were included in the retrospective cohort analysis. Data was obtained from US national electronic health records compiled in the TriNetX Research Network.

The number of children diagnosed with HCV infection, linkage to care, and prescribed DAAs were reported as primary outcomes. The impact of race and ethnicity on these outcomes was determined through logistic regression.

There were 928 children with HCV included in the final analysis, 32% of whom were linked to HCV care and 12% were prescribed a DAA. Compared with Black children, Hispanic and White children were significantly more likely to be linked to care, with odds ratios of 2.20 and 3.44, respectively, after adjustments for region, sex, and birth cohort.

Significant disparities

This data highlighted a low uptake of HCV care among pediatric patients. This included less than 1 in 3 children being linked to care and less than 1 in 8 receiving treatment. Additionally, racial and ethnic disparities were noted, with the odds of care being doubled in Hispanic children and tripled in White children compared to Black children.

“Targeting interventions toward increasing linkage to care could represent an opportunity to advance HCV elimination goals and reduce disparities,” concluded investigators.

The disparities in HCV care have been further proven by another study from researchers at Washington University School of Medicine in St. Louis.² This study found reduced odds of receiving HCV care among pregnant women, with odds decreased by 30% vs men and 11% vs women who were not recently pregnant.

Access remains a challenge

Megan Curtis, MD, assistant professor at Washington University and head of both studies, noted that effective treatments are available for patients with HCV. With 2 or 3 months of pills, 95% of patients will be cured. However, difficulties remain toward providing these treatments to the patients who need them most.

According to the data published in Pediatrics, children and recently pregnant women are at an increased risk of HCV infection, with factors such as race, geographic location, and age influencing whether they receive care. This included children in the South being less likely to receive treatment vs all other regions in the country.

While many of these disparities may be linked to socioeconomic factors, Curtis noted other factors that may contribute to low treatment rates in children. These include difficulty administrating medicine to a young child and clinicians delaying treatment because the disease may clear up on its own, though this is not always the case.

“We need to come up with better strategies for addressing hepatitis C,” said Curtis. “We have all the tools to eliminate it. We have medications that can treat it. We know the people who need to get it. We just need to step up the availability and the awareness. We could be done with hepatitis C in a generation.”

References

1. Curtis MR, Munroe S, Biondi BE, Ciaranello AL, Linas BP, Epstein RL. Disparities in linkage to care among children with hepatitis C virus in the United States. Pediatrics. 2025;155(5). doi:10.1542/peds.2024-068565
2. Hepatitis C treatment is not reaching some at-risk populations. Washington University in St. Louis. July 14, 2025. Accessed July 16, 2025.