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Outside exterior of the UNM Children's Hospital
By Elizabeth Gibson

Antiviral Advancements

Dr. Ricardo Castillo Leads Team Treating Children with Hepatitis C

Hepatitis C is the most common blood-borne disease in the United States, according to the New Mexico Department of Health. While not easy to catch, it can affect anyone – including newborn babies.

For more than half of people who become infected, the hepatitis C virus becomes a long-term, chronic infection that affects the liver. In some cases, chronic hepatitis C can result in serious, even life-threatening health problems like cirrhosis and liver cancer.

If a mother is known to have hepatitis C, there is a 5% chance of passing the virus on to her developing fetus. The chances are low, but neonatal care professionals advise screening for all babies born to a mother with the infection.

Since 2020, pediatric gastroenterologist Ricardo Castillo, MD, has led a team testing and treating infants born to mothers who are positive for hepatitis C.

 

Ricardo Castillo, MD
We’ve treated going on 30 kids now in the past two years. In terms of treatment arm of this program, we’re doing very well. It’s expanding and our next step is to go beyond UNM.
Ricardo Castillo, MD

“We’ve treated going on 30 kids now in the past two years,” said Castillo, who practices at The University of New Mexico Children’s Hospital. “In terms of treatment arm of this program, we’re doing very well. It’s expanding and our next step is to go beyond UNM.”

For years, treatment options were limited for children with hepatitis C because treatment drugs weren’t available for those under the age of 18. That is, Castillo said, until the U.S. Food and Drug Administration (FDA) began approving treatment for younger and younger children.

“Currently, the FDA allows us to treat kids as young as three years of age,” he said. “That’s been a major advance.”

Since the window between testing and treatment is much shorter than it was just a few years ago, the program is retaining more and more children for follow-up care.

Additionally, he said, the antiviral treatment itself has advanced significantly.

“It used to be that the treatment would have lots of complications,” he said. “But now the treatment is one pill a day for 12 weeks and there’s virtually no side effects. If they take the pill in compliance, then the chances are virtually 100% that they will be cured of hepatitis C.”

As May is designated as Hepatitis Awareness Month in the U.S., health care professionals are encouraging people to get tested, be aware of known risk factors and decrease social stigma around the virus.

Hepatitis C is often unfairly stigmatized due to it being a disease that’s sometimes associated with illicit drug use. That stigma, Castillo said, can often act as a barrier for someone to seek testing or care.

“Oftentimes when the mother comes in, she will have a lot of remorse and there are tears involved, so we’re just very supportive and grateful to her that she brought the baby in,” he said.

For many years, most doctors focused on only testing those at highest risk for the disease, including IV drug users – meaning many cases went undiagnosed. But policies have changed, Castillo said.

“At UNM, every pregnant mother is checked for hepatitis C, and then, if the results are positive, we can put the baby on our follow-up list,” he said. “Screening is the major next step in terms of how to deal with this disease in kids. I think we’ve stepped on up, at least for the city of Albuquerque.”

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