Over 3 million pediatric patients globally are estimated to be infected with HCV. Eradicating HCV in children helps prevent liver fibrosis, cirrhosis and hepatocellular carcinoma; reduces extra-hepatic manifestations of HCV; improves quality of life; and increases survival.

The 2019 American Association for the Study of Liver Diseases - Infectious Diseases Society of America (AASLD-IDSA) guidelines now recommend direct-acting antiviral (DAA) treatment with an approved regimen for all children and adolescents with HCV infection aged ≥ 3 years.

A new study published in the Journal of Viral Hepatitis presented a descriptive review of the new DAA treatments for HCV infection in the pediatric population.

It was stated that Ledipasvir/sofosbuvir (LDV/SOF) and sofosbuvir with ribavirin (SOF/RBV) are now approved for those ≥ 3 years old under specific clinical scenarios. Sofosbuvir/velpatasvir (SOF/VEL) is the only pangenotypic agent approved for children ≥ 6 years or ≥17 kg, and glecaprevir/pibrentasvir (GLE/PIB) is approved for adolescents ≥ 12 years old or ≥ 45kg. These DAA regimens are well-tolerated, and have comparable sustained virologic response rates at 12 weeks post-treatment compared to those reported in adults (close to 100%).

It was summarized that the introduction of DAAs has significantly changed the landscape of HCV treatment in adults and children with HCV infection, and has made the 2030 World Health Organization elimination goal seem attainable. It was stated that further studies are warranted to determine the optimal treatment for children with HCV infection, including timing, regimen, and duration.

Source: Journal of Viral Hepatitis. 2020 May 9. doi: 10.1111/jvh.13317.