Sofosbuvir-Velpatasvir for Chronic Hepatitis C Virus-Infected Children and Young Adults: Efficacy and Safety

Abstract

Background: Sofosbuvir-Velpatasvir has a high efficacy in adult patients with chronic hepatitis C infection .In this study, we reported treatment outcome with this drug in children and younger adults in Pakistani population.
 Objective: To assess the efficacy and safety of Sofosbuvir-velpatasvir in treating HCV-infected children and young adults. 
 Methods: This Interventional(Clinical trial) was done in Hepatitis clinic Jinnah Hospital, Lahore from April 10, 2021 to January 9, 2022.A total of 45 patients aged 6 to 18 years with detectable HCV RNA by PCR were registered. They were evaluated clinically. HCV genotyping was not done as Sofosbuvir – Velpatasvir is pangenotypic. All of the patients were given a single oral dose of Sofosbuvir-velpatasvir per day. Ribavirin was included for patients with compensated cirrhosis and for those who were treatment-experienced .Clinical assessment, CBC, LFT, RFT, and PT were performed monthly to determine side effects and safety. To evaluate treatment efficacy, HCV RNA was measured by PCR at 12 weeks (end of treatment) and 12 weeks post-treatment (sustained virological response). Treatment lasted for 24weeks for those with compensated cirrhosis. (Child Turcotte Pugh score 5 and 6; Child class A) or those who were treatment experienced. SPSS 24 was used for data analysis. 
 Results: Non cirrhotic patients had a mean age of 13.6±1.45 years, while those with compensated cirrhosis had 14.1±2.15 years. There were 63.6% males (28) and 36.4% female (17). 41 patients (91.11%) had undetectable HCV RNA by PCR ,12 weeks after treatment (Sustained virological response), indicating treatment effectiveness. Nine patients had HBV co-infection and took HBV medications as well during HCV treatment. At 12 weeks post-treatment, all HBV-coinfected patients had undetectable HCV RNA by PCR and lower HBV titers. Some of the patients experience minor side effects. However, none of the patients stopped their treatment due to these side effects Thus, this treatment was safe and effective. 
 Conclusion: Sofosbuvir/ velpatasvir has effectiveness and safety in treating HCV in children and young adults.