Treatment of Chronic Hepatitis C Infection with Direct Acting Antivirals in Adolescents with Thalassemia Major

Indian J Pediatr. 2019 Feb;86(2):148-153. doi: 10.1007/s12098-018-2752-7. Epub 2018 Aug 10.

Abstract

Objectives: To assess the efficacy and safety of sofosbuvir based generic Direct Acting Antivirals (DAAs) in treatment of Hepatitis C virus (HCV) in adolescents with thalassemia major (TM).

Methods: In this prospective single-arm study, 18 TM adolescents with Chronic Hepatitis C received sofosbuvir based generic DAAs. Patients with genotype 1 and genotype 3 received ledipasvir and daclatasvir respectively. Two cirrhotic patients with genotype 3 also received ribavirin.

Results: The mean age of patients was 15.1 y, of which 12 had genotype 1, 5 had genotype 3 and 1 had an undetermined genotype. Six patients had cirrhosis and 1 was treatment experienced. Sixteen of 18 patients (89%; 95% confidence interval 74 to 100%) achieved sustained virological response at 3 mo post completion of treatment with DAAs. There was a significant reduction in alanine aminotransferase levels (p < 0.001), HCV RNA load (p < 0.001) and ferritin levels (p < 0.026) at 3 mo post completion of treatment. There were no major adverse events associated with the use of DAAs.

Conclusions: Generic DAAs are effective and safe in TM adolescents with HCV.

Keywords: Daclatasvir; Hemoglobinopathy; Iron overload; Ledipasvir; Sofosbuvir.

MeSH terms

  • Adolescent
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Benzimidazoles / therapeutic use
  • Carbamates
  • Child
  • Drug Therapy, Combination / methods
  • Female
  • Fluorenes / therapeutic use
  • Genotype
  • Hepacivirus / classification
  • Hepacivirus / drug effects
  • Hepatitis C
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Imidazoles / therapeutic use
  • Liver Cirrhosis / complications
  • Male
  • Prospective Studies
  • Pyrrolidines
  • Ribavirin / therapeutic use
  • Sofosbuvir / administration & dosage
  • Sofosbuvir / therapeutic use
  • Sustained Virologic Response
  • Treatment Outcome
  • Valine / analogs & derivatives
  • Viral Load / drug effects
  • beta-Thalassemia / complications*

Substances

  • Antiviral Agents
  • Benzimidazoles
  • Carbamates
  • Fluorenes
  • Imidazoles
  • Pyrrolidines
  • ledipasvir
  • Ribavirin
  • Valine
  • daclatasvir
  • Sofosbuvir