{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:44:22Z","timestamp":1791776662220,"version":"4.3.4"},"reference-count":72,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Children represent only a small proportion of those infected with the hepatitis C virus (HCV) compared to adults. Nevertheless, a substantial number of children have chronic HCV infection and are at risk of complications including cirrhosis, portal hypertension, hepatic decompensation with hepatic encephalopathy, and hepatocellular carcinoma in adulthood. The overall prevalence of the HCV in children was estimated to be 0.87% worldwide. The HCV spreads through the blood. Children born to women with chronic hepatitis C should be evaluated and tested for HCV due to the known risk of infection. The course of treatment for hepatitis C depends on the type of HCV. Currently, there are two pan-genotype HCV treatments (Glecaprevir\/pibrentasvir and Sofosbuvir\/velpatasvir) for children. We aim to review the updated clinical guidelines on the management of HCV infection in children, including screening, diagnosis, and long-term monitoring, as well as currently published clinical trials and ongoing research on direct acting antiviral hepatitis C treatment in children.<\/jats:p>","DOI":"10.3390\/pathogens13020180","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T08:02:17Z","timestamp":1708070537000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Updated Clinical Guidelines on the Management of Hepatitis C Infection in Children"],"prefix":"10.3390","volume":"13","author":[{"given":"Chaowapong","family":"Jarasvaraparn","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, Indianapolis, IN 46201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8159-387X","authenticated-orcid":false,"given":"Christopher","family":"Hartley","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7288-5459","authenticated-orcid":false,"given":"Wikrom","family":"Karnsakul","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"ref_1","unstructured":"Basit, H., Tyagi, I., and Koirala, J. (2023). StatPearls, StatPearls Publishing LLC."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1016\/j.jhep.2014.07.027","article-title":"Global epidemiology and genotype distribution of the hepatitis C virus infection","volume":"61","author":"Gower","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/MPG.0000000000003099","article-title":"Seroprevalence of Hepatitis C in Children Without Identifiable Risk-Factors: A Systematic Review and Meta-Analysis","volume":"72","author":"Melikoki","year":"2021","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S2468-1253(19)30385-1","article-title":"Global prevalence of hepatitis C virus in children in 2018: A modelling study","volume":"5","author":"Schmelzer","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_5","unstructured":"(2024, January 10). Hepatitis C Surveillance 2021. Center for Disease Control and Prevention. Updated August 7, 2023, Available online: https:\/\/www.cdc.gov\/hepatitis\/statistics\/2021surveillance\/hepatitis-c.htm#anchor_03753."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1093\/cid\/ciu643","article-title":"Emerging Epidemic of Hepatitis C Virus Infections Among Young Nonurban Persons Who Inject Drugs in the United States, 2006\u20132012","volume":"59","author":"Suryaprasad","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"103930","DOI":"10.1016\/j.drugpo.2022.103930","article-title":"How the rural risk environment underpins hepatitis C risk: Qualitative findings from rural southern Illinois, United States","volume":"112","author":"Walters","year":"2023","journal-title":"Int. J. Drug Policy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"775","DOI":"10.7326\/M16-2350","article-title":"Hepatitis C Virus Infection Among Reproductive-Aged Women and Children in the United States, 2006 to 2014","volume":"166","author":"Ly","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1093\/cid\/ciu447","article-title":"Vertical transmission of hepatitis C virus: Systematic review and meta-analysis","volume":"59","author":"Benova","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"109","DOI":"10.7326\/0003-4819-158-2-201301150-00575","article-title":"Reducing risk for mother-to-infant transmission of hepatitis C virus: A systematic review for the U.S. Preventive Services Task Force","volume":"158","author":"Cottrell","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1002\/hep.20030","article-title":"Long-term outcome (35 years) of hepatitis C after acquisition of infection through mini transfusions of blood given at birth","volume":"39","author":"Casiraghi","year":"2004","journal-title":"Hepatology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1086\/315264","article-title":"Persistence rate and progression of vertically acquired hepatitis C infection. European Paediatric Hepatitis C Virus Infection","volume":"181","author":"Tovo","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jpeds.2006.11.037","article-title":"Clinical spectrum and histopathologic features of chronic hepatitis C infection in children","volume":"150","author":"Mohan","year":"2007","journal-title":"J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1097\/INF.0b013e318236ac37","article-title":"Diagnosis and management of hepatitis C virus-infected children","volume":"30","author":"Jhaveri","year":"2011","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1542\/peds.98.2.211","article-title":"Clinical and virologic features of hepatitis C virus infection associated with intravenous immunoglobulin","volume":"98","author":"Jonas","year":"1996","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1056\/NEJM200001273420414","article-title":"Hepatitis C in children","volume":"342","author":"Birnbaum","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1002\/hep.22094","article-title":"Pathology of chronic hepatitis C in children: Liver biopsy findings in the Peds-C Trial","volume":"47","author":"Goodman","year":"2008","journal-title":"Hepatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1053\/j.gastro.2008.02.082","article-title":"Long-term course of chronic hepatitis C in children: From viral clearance to end-stage liver disease","volume":"134","author":"Bortolotti","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1002\/hep.26519","article-title":"Evaluating progression of liver disease from repeat liver biopsies in children with chronic hepatitis C: A retrospective study","volume":"58","author":"Mohan","year":"2013","journal-title":"Hepatology"},{"key":"ref_20","unstructured":"(2024, January 10). Available online: https:\/\/www.cdc.gov\/hepatitis\/hcv\/index.htm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6902a1","article-title":"CDC Recommendations for Hepatitis C Screening Among Adults\u2014United States, 2020","volume":"69","author":"Schillie","year":"2020","journal-title":"MMWR Recomm. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e3340","DOI":"10.1093\/cid\/ciaa949","article-title":"Nucleic Acid Testing for Diagnosis of Perinatally Acquired Hepatitis C Virus Infection in Early Infancy","volume":"73","author":"Gowda","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/j.1651-2227.2005.tb01916.x","article-title":"Excluding hepatitis C virus (HCV) infection by serology in young infants of HCV-infected mothers","volume":"94","author":"England","year":"2005","journal-title":"Acta Paediatr."},{"key":"ref_24","unstructured":"(2024, January 10). Available online: https:\/\/www.cdc.gov\/hepatitis\/."},{"key":"ref_25","first-page":"536","article-title":"Black Box Warning for Possible HBV Reactivation During DAA Therapy for Chronic HCV Infection","volume":"13","author":"Pockros","year":"2017","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/MPG.0b013e318170af04","article-title":"Hepatocellular carcinoma in 2 young adolescents with chronic hepatitis C","volume":"48","author":"Langham","year":"2009","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1182\/blood.V95.10.3065","article-title":"Hepatitis C infection among survivors of childhood cancer","volume":"95","author":"Strickland","year":"2000","journal-title":"Blood"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1002\/hep.29913","article-title":"Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases","volume":"68","author":"Marrero","year":"2018","journal-title":"Hepatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jpeds.2021.02.012","article-title":"Improvement in Liver Stiffness in Pediatric Patients with Hepatitis C Virus after Treatment with Direct Acting Antivirals","volume":"233","author":"Mogahed","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jpeds.2020.12.031","article-title":"Changes in Liver Stiffness and Noninvasive Fibrosis Scores in Egyptian Adolescents Successfully Treated with Ledipasvir-Sofosbuvir for Chronic Hepatitis C Virus Infection","volume":"231","author":"Fahmy","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"ElShahawy, A., El-Raziky, M.S., Sharaf, S.A., Elsharkawy, A., Enayet, A., and Taher, H. (2022). Accuracy of noninvasive methods for the diagnosis of liver fibrosis in children with chronic viral hepatitis. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02570-w"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jpeds.2005.12.051","article-title":"Acute liver failure in children: The first 348 patients in the pediatric acute liver failure study group","volume":"148","author":"Squires","year":"2006","journal-title":"J. Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1093\/cid\/cix1007","article-title":"Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy","volume":"66","author":"Boerekamps","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3350\/cmh.2022.0349","article-title":"Acute hepatitis C virus infection: Clinical update and remaining challenges","volume":"29","author":"Liu","year":"2023","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1002\/hep.32393","article-title":"Sofosbuvir-velpatasvir-voxilaprevir in adolescents 12 to 17 years old with HCV infection","volume":"76","author":"Indolfi","year":"2022","journal-title":"Hepatology"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Flamm, S., Lawitz, E., Borg, B., Charlton, M., Landis, C., Reddy, K.R., Shiffman, M., Alsina, A., Chang, C., and Ravendhran, N. (2023). Efficacy and Safety of Sofosbuvir\/Velpatasvir Plus Ribavirin in Patients with Hepatitis C Virus-Related Decompensated Cirrhosis. Viruses, 15.","DOI":"10.3390\/v15102026"},{"key":"ref_37","first-page":"218","article-title":"Mechanism of action of ribavirin in the treatment of chronic hepatitis C","volume":"3","author":"Te","year":"2007","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1002\/bdr2.2094","article-title":"Final results from the ribavirin pregnancy registry, 2004\u20132020","volume":"114","author":"Sinclair","year":"2022","journal-title":"Birth Defects Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1515\/jtim-2017-0007","article-title":"Direct acting anti-hepatitis c virus drugs: Clinical pharmacology and future direction","volume":"5","author":"Geddawy","year":"2017","journal-title":"J. Transl. Int. Med."},{"key":"ref_40","unstructured":"Merck &, Co., Inc. (2014). Interferon Alpha [Package Insert], Merck & Co., Inc."},{"key":"ref_41","unstructured":"Merck &, Co., Inc. (2013). Ribivirin [Package Insert], Merck & Co., Inc."},{"key":"ref_42","unstructured":"AbbVie Inc. (2023). MAVYRET (Glecaprevir\/Pibrentasvir) [Package Insert], AbbVie Inc."},{"key":"ref_43","unstructured":"Gilead Sciences Inc. (2014). Harvoni (Ledipasvir\/Sofosbuvir) [Package Insert], Gilead Sciences Inc."},{"key":"ref_44","unstructured":"Gilead Sciences Inc. (2016). Epclusa (Sofosbuvir\/Velpatasvir) [Package Insert], Gilead Sciences Inc."},{"key":"ref_45","unstructured":"Bristol-Myers Squibb (2017). Daklinza (Dacltasvir) [Package Insert], Bristol-Myers Squibb."},{"key":"ref_46","unstructured":"Merck &, Co., Inc. (2016). Zepatier (Elbasvir\/Grazoprevir) [Package Insert], Merck & Co., Inc."},{"key":"ref_47","unstructured":"AbbVie Inc. (2014). Viekira Pak (Ombitasvir\/Paritaprevir\/Ritonavir Plus Dasabuvir) [Package Insert], AbbVie Inc."},{"key":"ref_48","unstructured":"Gilead Sciences Inc. (2017). Vosevi (Sofosbivur\/Velpatasvir\/Voxilaprevir) [Package Insert], Gilead Sciences Inc."},{"key":"ref_49","unstructured":"Janssen Products (2013). Olysio (Simeprevir) [Package Insert], Janssen Products."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/hep.28995","article-title":"The safety and effectiveness of ledipasvir-sofosbuvir in adolescents 12\u201317 years old with hepatitis C virus genotype 1 infection","volume":"66","author":"Balistreri","year":"2017","journal-title":"Hepatology"},{"key":"ref_51","unstructured":"Bristol-Myers Squibb (2017). Sunvepra (Asunaprevir) [Package Insert], Bristol-Myers Squibb."},{"key":"ref_52","unstructured":"Merck & Co., Inc. (2011). Victrelis (Boceprevir) [Package Insert], Merck & Co., Inc."},{"key":"ref_53","unstructured":"Vertex Pharmaceuticals Incorporated (2011). Incivek (Telaprevir) [Package Insert], Vertex Pharmaceuticals Incorporated."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1002\/hep.29278","article-title":"Sofosbuvir and ribavirin in adolescents 12\u201317 years old with hepatitis C virus genotype 2 or 3 infection","volume":"66","author":"Wirth","year":"2017","journal-title":"Hepatology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1002\/hep.30123","article-title":"Safety and Efficacy of Ledipasvir-Sofosbuvir with or Without Ribavirin for Chronic Hepatitis C in Children Ages 6-11","volume":"68","author":"Murray","year":"2018","journal-title":"Hepatology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1002\/hep.30830","article-title":"Ledipasvir-Sofosbuvir for 12 Weeks in Children 3 to <6 Years Old with Chronic Hepatitis C","volume":"71","author":"Schwarz","year":"2020","journal-title":"Hepatology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1002\/hep.30840","article-title":"Pharmacokinetics, Safety, and Efficacy of Glecaprevir\/Pibrentasvir in Adolescents with Chronic Hepatitis C Virus: Part 1 of the DORA Study","volume":"71","author":"Jonas","year":"2020","journal-title":"Hepatology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/hep.30821","article-title":"Sofosbuvir and Ribavirin Therapy for Children Aged 3 to <12 Years with Hepatitis C Virus Genotype 2 or 3 Infection","volume":"71","author":"Rosenthal","year":"2020","journal-title":"Hepatology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1007\/s12325-020-01389-9","article-title":"Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir Mini-Tabs Plus Ribavirin for Children Aged 3\u201311 Years with Hepatitis C Genotype 1a","volume":"37","author":"Rosenthal","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_60","unstructured":"(2024, January 10). Study to Investigate the Safety and Efficacy of Sofosbuvir\/Velpatasvir in Adolescents and Children with Chronic HCV Infection. Clinical Trials.gov Website. Updated October, 2020, Available online: https:\/\/clinicaltrials.gov\/study\/NCT03022981#publications."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/hep.31841","article-title":"Pharmacokinetics, Safety, and Efficacy of Glecaprevir\/Pibrentasvir in Children with Chronic HCV: Part 2 of the DORA Study","volume":"74","author":"Jonas","year":"2021","journal-title":"Hepatology"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e0031","DOI":"10.1097\/HC9.0000000000000031","article-title":"Elbasvir\/grazoprevir in children aged 3\u201318 years with chronic HCV genotype 1 or 4 infection: A pharmacokinetic modeling study","volume":"7","author":"Wirth","year":"2023","journal-title":"Hepatol. Commun."},{"key":"ref_63","unstructured":"(2023, December 20). Available online: https:\/\/www.hcvguidelines.org\/unique-populations\/children."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/HEP.0000000000000580","article-title":"The Liver Meeting: Boston, Massachusetts Nov 10\u201314, 2023","volume":"78","author":"Stockdale","year":"2023","journal-title":"Hepatology"},{"key":"ref_65","unstructured":"Bhattacharya, D., Aronsohn, A., Price, J., and Lo Re, V. (2023). Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clin. Infect. Dis., ciad319."},{"key":"ref_66","unstructured":"(2024, January 11). Study to Evaluate Adverse Events and Change in Disease Activity in Adult and Adolescent Participants with Acute Hepatitis C Virus (HCV) Infection on Treatment with Oral Tablets of Glecaprevir (GLE)\/Pibrentasvir (PIB). Clinicaltrials.gov Website. Updated July 2021, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04903626."},{"key":"ref_67","unstructured":"(2024, January 11). Prevalence of Seroconversion of Hepatitis c Virus among Children with CKD on Regular Hemodialysis. Clinicaltrials.gov Website. Updated October 2023, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06104046."},{"key":"ref_68","unstructured":"(2024, January 11). A Study of the Safety, Effectiveness and Clinical Use of Maviret in Adolescent Patients with Chronic Hepatitis C Virus. Clinicaltrials.gov Website. Updated December 2023, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04214028."},{"key":"ref_69","unstructured":"(2024, January 11). Study of DAA Treatment for Children and Adolescents with Active HCV Infection in Cambodia (HEPEDIAC). Clinicaltrials.gov Website. Updated August 2023, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05992077."},{"key":"ref_70","unstructured":"(2024, January 11). Clinical Pharmacokinetics of Daclatasvir\/Sofosbuvir in Adolescents with Hepatitis C Virus. Clincialtrials.gov Website. Updated March 2023, Available online: https:\/\/clinicaltrials.gov\/study\/NCT03540212."},{"key":"ref_71","unstructured":"(2024, January 11). (NCT05854511) Pharmacokinetics, Safety, Efficacy and Acceptability of Daclatasvir Plus Sofosbuvir in HCV-Infected Children. Clinicaltrials.gov Website. Updated May 2023, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05854511."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e676","DOI":"10.1016\/S2214-109X(15)00156-4","article-title":"Disparity in market prices for hepatitis C virus direct-acting drugs","volume":"3","author":"Cohn","year":"2015","journal-title":"Lancet Glob. Health"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/2\/180\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:00:52Z","timestamp":1760104852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/2\/180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,16]]},"references-count":72,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["pathogens13020180"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13020180","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,16]]}}}