Efficacy of Sofosbuvir and Ribavirin in Children Presenting with Hepatitis C at Tertiary Care Hospital, Faisalabad
DOI:
https://doi.org/10.51985/JBUMDC2021128Keywords:
Chronic Hepatitis C, Children, Antiviral, Sofosbuvir, RibavirinAbstract
Objectives: To assess efficacy, safety, and outcome of combination of Sofosbuvir and Ribavirin in various genotypes, in
children with hepatitis C infection.
Study design and setting: It was a quasi-experimental study, conducted at the Gastroenterology and Hepatology Department,
Children Hospital Faisalabad, from August 2017 to August 2021.
Methodology: 50 confirmed cases of HCV infection aged 5 to 18 years, were given an oral dose of Sofosbuvir and Ribavirin
daily for 12 weeks. PCR was assessed at 4 weeks (for Rapid Viral Response (RVR)) and repeated at 8 weeks and 12 weeks
(for Early Viral Response (EVR)) and again 12 weeks after the completion of therapy for Sustained Viral Response (SVR)).
Primary outcome was the number who achieved an SVR at 12 weeks (SVR12) after completion of treatment with a viral
load below quantitation level.
Results: Genotype 3 was found in 80% , type 1 in 6% , type 2 in 4% and 10% were untypeable. All children were PCR
positive at presentation; 96% became PCR negative at 4 weeks (RVR), while 100 percent were negative at 8 weeks, 12
weeks (EVR), and SVR 12 weeks after completion of 12 week course was 100%.
Conclusion: Although majority of patients were Genotype 3, 12 week course of Sofosbuvir and Ribavirin of hepatitis
C-infected children was highly effective, with 100 percent PCR-negative cases at 8 weeks and 12 weeks with only minor
side effects, and, SVR of 100% twelve weeks after completion of therapy
References
Lombardi A, Mondelli MU; ESCMID Study Group for Viral
Hepatitis (ESGVH). Hepatitis C: Is eradication possible?
Liver Int. 2019;39(3):416-426. Doi; 10.1111/liv. 14011. E
pub 2019 Jan 10. PMFD: 30472772.
Aiman Arshad, Usman Ali Ashfaq. Epidemiology of Hepatitis
infection in Pakistan; current estimate and major risk factors.
Crit Rev EukaryotGene Exp. 2020; 20: 587.
World Health Organisation. Global Health Sector Strategy
on Viral Hepatitis 2016-2021. Geneva Switzerland : World
Health Organisation ; 2016.
Petruzziello A, Marigliano S, Loquercio G, Cozzolino A,
Cacciapuoti C. Global epidemiology of hepatitis C virus
infection: An up-date of the distribution and circulation of
hepatitis C virus genotypes. World J Gastroenterol.
;22(34):7824-40. Doi: 10.3748/wjg.v22. 134.7824.
Haqqi A, Munir R, Khalid M, Khurram M, Zaid M, Ali M,
et. al. Prevalence of Hepatitis C Virus Genotypes in Pakistan:
Current Scenario and Review of Literature. Viral Immunol.
;32(9):402-413. https:// doi.org/10.1089/vim.2019.0058.
Sohail Akhtar, Jamal Abdul Nasir, Andrew Hinde. The
prevalence of Hepatitis C virus infection in Beta thalassemia
patients in Pakistan; a systematic review and meta-analysis.
BMC Public Health. 2020;20:587. https:// doi.org/10-
/s12889-020-8414-5.
Samo AA, Laghari ZA, Baig NM, Khoso GM. Prevalence
and Risk Factors Associated with Hepatitis B and C in
Nawabshah, Sindh, Pakistan. Am J Trop Med Hyg.
;104(3):1101–5. Doi: 10.4269/ajtmh. 20-1228.
Treatment of adolescents and children with chronic HCV
infection. Policy Brief. Geneva. World Health Organisation
Hashmi MA, Cheema HA. Effectiveness and Safety of
Sofosbuvir in Treatment-Näive Children with Hepatitis C
Infection. J Coll Physicians Surg Pak. 2017;27(7):423-426.
Ghany MG, Morgan TR; AASLD-IDSA Hepatitis C Guidance
Panel. Hepatitis C Guidance 2019 Update: American
Association for the Study of Liver Diseases-Infectious Diseases
Society of America Recommendations for Testing, Managing,
and Treating Hepatitis C Virus Infection. Hepatology.
;71(2):686-721. https://doi.org/10.1002/hep.31060
Rosenthal, P. Kathleen B Schwartz, Regino P Gonzales-Peralta
et al. Sofosbuvir and Ribavirin therapy for children aged 3
to 12 years with hepatitis C virus genotype 2 or 3 infection.
Hepatology, 2020;71(1): 31-43
Rosenthal P, Schwarz KB, Gonzalez-Peralta RP, Lin CH,
Kelly DA, Nightingale S, et. al. Sofosbuvir and Ribavirin
Therapy for Children Aged 3 to <12 Years With Hepatitis C
Virus Genotype 2 or 3 Infection. Hepatology. 2020;71(1):31-
https://researcherprofiles.org/profile/57844836
Karnsakul W, Schwarz KB. Management of Hepatitis C
Infection in children in the era of Direct-acting Antiviral
Agents. J Viral Hepat. 2019;26(9):1034-1039. doi:
1111/jvh.13113.
Squires JE, Balistreri WF. Hepatitis C virus infection in
children and adolescents. Hepatology communications.
;1(2):87-98. https://doi.org/10.1002/hep4.1028.
Hashmi, MA and Anwar A. Risk Factors for Viral Hepatitis
B and C Infection in Children. PAFMJ, 2018; 68(3): 627-33.
Huang Y, Li MH, Hou M, Xie Y. Peginterferon alfa-2a for
the treatment of chronic hepatitis C in the era of direct-acting
antivirals. Hepatobiliary Pancreat Dis Int. 2017;16(5):470-
Murray KF, Balistreri WF, Bansal S, Whitworth S, Evans
HM and Gonzalez-Peralta RP et. al. Safety and Efficacy of
Ledipasvir–Sofosbuvir With or Without Ribavirin for Chronic
Hepatitis C in Children Ages 6-11. Hepatology.
;68(6):2158-66. Doi: 10.1002/hep.30123.
Schwarz KB, Rosenthal P, Murray KF, Honegger JR, Hardikar
W, Hague R, Mittal N, Massetto B, Brainard DM, Hsueh CH,
Shao J. Ledipasvir-sofosbuvir for 12 weeks in children 3 to<
years old with chronic hepatitis C. Hepatology.
;71(2):422-30. Doi: 10.1002/hep.30830.
El-Araby HA, Behairy BE, El-Guindi MA, Adawy NM, Allam
AA, Sira AM, et. al. Generic sofosbuvir/ledipasvir for the
treatment of genotype 4 chronic hepatitis C in Egyptian
children (9-12 years) and adolescents. Hepatol Int.
;13(6):706-714. Doi: 10.1007/s12072-019-09985-w.
Alkaaby BA, Al-Ethawi AE. The effectiveness of oral antiviral
(Sofosbuvir/Ledipasvir) in treating children with HCV
infection. Pak J Med Sci. 2018;34(6):1353-1356. Doi:
12669/pjms.346.15722.
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Copyright (c) 2023 Nagina Shahzadi , Naureen Kanwal Satti, Huma Arshad, Nadeem Hashmat
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