Results of therapy with direct-acting antiviral drugs in children with chronic hepatitis C

Abstract

Objective. To evaluate the efficacy and safety of glecaprevir/pibrentasvir among children with chronic hepatitis C (CHC). Patients and methods. This study included 15 children diagnosed with CHC (10 boys and 5 girls) aged between 12 and 17 years (median age 14.9 [14.1;15.4] years). All children received Maviret (glecaprevir/pibrentasvir, GLE/PIB) at a fixed dose of 300 mg of GLE plus 120 mg of PIB (3 tablets containing 100 mg/40 mg of GLE/PIB) with food once a day; treatment duration depended on the virus genotype, presence or absence of liver cirrhosis, and previous treatment for CHC. Results. The majority of patients (n = 11) had earlier received a course of antiviral therapy with interferon: 5 children received both interferon α-2a monotherapy and pegylated interferon α-2b with ribavirin at different times, while 6 children received only a course of pegylated interferon α-2b with ribavirin. Treatment was prescribed in accordance with patient characteristics. Fourteen children started an 8-week course of GLE/PIB; 1 boy infected with hepatitis C with 3 genotype received a 16-week course of GLE/PIB due to a history of treatment failure on interferons. Sustained virologic response (SVR) was registered in all study participants 12 weeks after treatment completion. None of the patients interrupted treatment or experienced virological breakthrough. All observed adverse events were mild; all of them were not associated with the therapy: 4 children (26.7%) had upper respiratory tract infections, catarrhal otitis media (6.7%), fatigue (6.7%), and metatarsal fracture (6.7%). Conclusion. Combined antiviral therapy demonstrated SVR in 100% of children with CHC. All adverse events were mild and did not require treatment interruption or withdrawal. Key words: chronic hepatitis C, antiviral therapy, direct-acting antiviral drugs, children, efficacy