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Clinical utility of ledipasvir/sofosbuvir in the treatment of adolescents and children with hepatitis C

Authors Yang CHT, Goel A, Ahmed A

Received 27 April 2018

Accepted for publication 25 June 2018

Published 30 July 2018 Volume 2018:9 Pages 103—110


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Alastair Sutcliffe

Christine Hong Ting Yang,1 Aparna Goel,2 Aijaz Ahmed2

1Division of Pediatric Gastroenterology, Stanford University School of Medicine, Stanford, CA, USA; 2Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA

Abstract: Chronic infection with hepatitis C virus (HCV) affects an estimated 0.1%–2% of the pediatric population in the United States. While the clinical course in young children is indolent, adolescents who contract HCV have a disease course similar to adults, with a 26-fold increased risk of chronic liver disease-associated mortality, hepatocellular carcinoma, and need for curative liver transplantation. Furthermore, adolescent patients are entering childbearing age and carry a risk of passing HCV to their offspring via vertical transmission. Pegylated-interferon (PEG-IFN) with ribavirin was previously the only treatment option for pediatric patients with chronic hepatitis C (CHC), but the high likelihood of adverse reactions and subcutaneous route of administration limited its use and efficacy. Recently, the direct-acting antivirals (DAAs) ledipasvir (LDV) and sofosbuvir (SOF) were approved for adolescents with CHC. This review discusses the natural history of CHC in pediatric patients, data supporting LDV/SOF in adolescents, and ongoing studies evaluating DAAs in pediatric patients.

Keywords: hepatitis C virus, chronic hepatitis C, adolescent, pediatric, direct-acting antivirals

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