Follow-up of chronic paediatric hepatitis C virus in a low-/middle-income country

Acta Paediatr. 2020 Dec;109(12):2699-2705. doi: 10.1111/apa.15333. Epub 2020 May 20.

Abstract

Aim: Follow-up of chronic hepatitis C virus (HCV) infection following Interferon (IFN) plus Ribavirin (RBV) or direct-acting antiviral (DAA) drug therapy in a cohort of paediatric outpatients as confirmed by a sustained virologic response (SVR).

Methods: This study included a cohort of 60 patients (6-18 years), divided into 2 groups: Group 1:21 patients who completed treatment with IFN/RBV. Group 2:39 treated with dual DAA therapy: 19 with Sofosbuvir/Ledipasvir (SOF/LED) and 20 with Sofosbuvir/Daclatasvir (SOF/DCV).

Results: Group 1:12 (57.1%) were cured, six were IFN/RBV treatment failure then subsequently treated with DAAs successfully, and three had liver transplants. IFN/RBV side effects were reported in all patients; however, fibrosis regressed in two cured patients. Group 2: all were cured. HCV RNA became negative in all DAAs-treated patients at weeks 2, 4 and 12 of treatment (100%) as well as SVR after 12 weeks (100%). Thirty patients reported no adverse side effects whereas only nine suffered minor side effects.

Conclusions: In our cohort, SOF/LED therapy and SOF/DCV therapy were extremely safe and effective with 100% SVR and negligible short-term side effects. IFN/RBV therapy was much less effective (SVR 57.1%) and accompanied with short-term side effects. Fibrosis might stop and even regress with successful treatment.

Keywords: DAAs; HCV; SVR; interferon; paediatrics.

MeSH terms

  • Antiviral Agents* / therapeutic use
  • Child
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Genotype
  • Hepacivirus / genetics
  • Hepatitis C, Chronic* / drug therapy
  • Humans
  • Treatment Outcome

Substances

  • Antiviral Agents