Published: 2021-01-27

Effectiveness of directly acting oral antivirals in treatment of chronic HCV infection in children - experience from a tertiary care institute in southern India

Senthil Kumar Ramalingam, Winston Thomas, Nirmala Dheivamani, Sathish Kumar Elumalai


Background: Worldwide, an estimated 71 million people are chronically infected with HCV, of which an estimated 2.1- 5.0 million are children aged ≤15 years. Children with chronic HCV infection have fewer treatment options than adults. Very few reports are available on HCV infection, treatment strategies and its outcome particularly in pediatric population. In this background, we evaluated the effectiveness and safety of Sofosbuvir/Ledipasvir in treating HCV infection in children.

Methods: In this retrospective study, a total of 33 children with HCV positive status, 12 cases (children above 12 years of age) were selected for treatment. HCV-RNA quantitative assay, genotyping was carried out. Children above 12 years with HCV genotype 1 were treated with tablet ledipasvir-sofosbuvir (90/400 mg) orally once a day as morning dose for 12 weeks. Children with genotype 3 were treated with sofosbuvir 400 mg and weight based ribavirin for 24 weeks. Viral load was repeated after 12 weeks of completion of treatment with antivirals for sustained virological response (SVR 12).

Results: Out of the 12 patients 11 patients had genotype 1 (5/11 had subtype-1a and 6/11 had subtype-1b) infection and only 1 patient has genotype 3 (subtype-3a). All of them attained SVR at the end of 12 weeks. The regimen was well tolerated and there were no side effects noted by the children and their caretakers. Drug compliance and the palatability of the drugs were good.

Conclusions: Ledipasvir-sofosbuvir combination was highly effective at treating children with chronic HCV genotype 1 infection. The availability of an all oral, direct-acting antiviral regimen for paediatric population with chronic HCV would improve care for patients who currently have limited treatment options.



Hepatitis C virus, Ledipasvir, Sofosbuvir, Sustained virological response

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