In recognition of World Hepatitis Day, FISPGHAN joins the global call to eliminate hepatitis C infection, particularly in children and adolescents, who are among the most underserved populations affected by this disease.

To whom it may concern:

There are more than 3.2 million children in the world with hepatitis C virus (HCV) infection, the majority of whom acquired from their mothers. It is a tragic irony that although we now have highly effective and safe direct-acting antiviral agents capable of curing HCV in 8-12 weeks in children as young as 3 years of age, the vast majority of these children remain undiagnosed or untreated. Consequently, they face a high lifetime risk of chronic liver disease, cirrhosis, and liver cancer. Multiple studies have shown that eliminating HCV in young children is highly cost-effective, not to mention sparing these unfortunate children from suffering and stigma.

We are therefore recommending the following to

A. Health departments—adopt the screening recommendations of the following:

1) The American Association for the Study of Liver Diseases and the Infectious Disease Society of America (2022) to do one-time screening of all subjects <18 years of age at increased risk for HCV with anti-HCV antibody with reflex testing of HCV RNA.

2) The US Centers for Disease Control and Prevention to test all perinatally exposed infants and children aged 2-17 months, with HCV RNA.

B. Pediatric societies—educate and empower health care providers

1) To perform this screening

2) To treat all HCV-infected children 3 years of age and older

C. Corporations – work with governments to provide the necessary therapeutics and testing at the most reasonable cost basis possible for children and adolescents.

1) To developers of HCV—Real-Time PCR Testing for HCV

2) To pharmaceutical companies have obtained FDA and EMA approval for their direct-acting antiviral agents for children

D. Foundations—work with the four groups below to achieve the elimination of HCV in children worldwide

1) UNICEF

2) GATES FOUNDATION

3) IMPAACT

4) CARTER CENTER

Drafted by the following members of the Group of Pediatric Hepatologists:

Kathleen B. Schwarz, MD, FAASLD, FNASPGHAN, Rady Children’s Hospital/UCSD/ San Diego, CA, USA.

Yen-Hsuan Ni, MD, PhD, National Taiwan University, Taiwan

Anupam Sibal, MD, Group Medical Director, Apollo Hospitals Group, India

Giuseppe Indolfi, MD, PhD, Meyer Children's University Hospital of Florence, Italy

Deirdre Kelly, MD, Children’s NHS Foundation Trust, UK

Patricia D’Alia MD, Hospital General de Niños Pedro de Elizalde, Argentina

Carol Lezama Elecharri, MD, Hospital General de Niños Ricardo Gutierrez, Argentina

Carmen Esther Lopez Gudel, MD, Venezuela

Natascha Silva Sandy, MD, PhD, Hospital Israelita Albert Einstein, Brazil