Hepatitis C Virus Treatment Response to Direct-acting Antivirals Among Adolescents With HIV/HCV Coinfection: Real-world Data From Ukraine

Abstract

Direct-acting antivirals (DAAs) have been approved for treating chronic hepatitis C virus (HCV) in children and adolescents. Although DAAs have been used in real-world settings for the treatment of HCV monoinfected adolescents, few reports of real-world use of DAAs in children and adolescents who are coinfected with human immunodeficiency virus (HIV) are available. We evaluated the real-world safety and effectiveness of DAAs in HIV/HCV coinfected adolescents from the Ukraine Paediatric HIV Cohort Study including all those for whom treatment outcomes were available by April 2021. Overall, 6 coinfected adolescents had received DAA treatment; 4 with sofosbuvir/ledipasvir (SOF/LDV), 1 with SOF/ LDV+ribavirin, and 1 with SOF/daclatasvir. No patient discontinued treatment due to adverse events and no serious adverse events were reported. All 6 patients achieved sustained virologic response by 12 weeks after the end of therapy. DAA treatment was well tolerated and effective in adolescents with HIV/HCV coinfection in a real-world setting.

Effectiveness and Safety of Direct-acting Antivirals for Treatment of Adolescents With HCV/HIV Coinfection: Real-world Data From Europe

“…There were no reports of serious clinical or laboratory adverse events or adverse events leading to treatment change or discontinuation. Our conservative SVR12 results are lower than previously reported due to missing data in 4 participants, but among those with data, the DAA safety was consistent with case-studies reporting excellent safety in adolescents 6 , 7 and adults with HCV/HIV coinfection. 13 , 14 The favorable treatment outcomes support WHO and European recommendations to treat all children and adolescents with chronic HCV 3 years old and above, including those with normal liver function tests and no evidence of liver fibrosis.…”

“… 2 Recent case-series from Poland and Ukraine reported DAA use in 2 and 6 HCV/HIV coinfected adolescents respectively, all of whom achieved sustained virologic response (SVR). 6 , 7 In this study, we describe the safety and effectiveness of DAAs in adolescents, using real-world data from a large observational pediatric HIV cohort collaboration in Europe.…”

Defer no more: advances in the treatment and prevention of chronic hepatitis C virus infection in children

“…Among HIV/HCV-coinfected adults, HCV treatment is highly efficacious with curative rates comparable to those with HCV monoinfection [50,51]. Thus far, at least 11 cases of successful DAA treatment have been reported in coinfected children [15 ▪▪ ,16,52 ▪ ,53].…”