Treatment of Hepatitis C in a Case of Pediatric B-Cell Acute Leukemia

Abstract

The prevalence of hepatitis C virus (HCV) infection in Pediatric patients with lymphoproliferative diseases has most commonly been reported with B cell Non-Hodgkin lymphoma. Case studies have reported the requirement of dose reduction or suspension of chemotherapy in 80% of Pediatric ALL cases who are anti-HCV positive owing to hepatotoxicity. The standard of care anti HCV therapy in children aged 3-17 years had been peginterferon and ribavirin for 48 weeks. FDA approved pan-genotypic, anti- HCV regimen, sofosbuvir/velpatasvir [SOF/VEL], for the Pediatric population >6yrs of age or >17 kg body weight in March 2020. We herein report a case of an HCV infected Pediatric B cell ALL patient who was treated with SOF/VEL concomitantly with an intensive chemotherapy regimen. Child tolerated the full dose chemotherapy along with antivirals for 12 weeks and was in morphological remission with sustained virological response.

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

“…Early eradication of HCV is of paramount importance to prevent liver-related complications. Single patient case reports or case series of successful HCV treatment using DAA regimens have been reported in children with haematologic malignancies and those undergoing haematopoietic stem cell therapy [25,40,41 ▪ ,42,43 ▪ ,44]. Safety profiles were excellent, with no reported DAA-related serious adverse events, chemotherapy interruptions or significant toxicities due to drug interactions [25,40,41 ▪ ,42,43 ▪ ,44].…”

“…Single patient case reports or case series of successful HCV treatment using DAA regimens have been reported in children with haematologic malignancies and those undergoing haematopoietic stem cell therapy [25,40,41 ▪ ,42,43 ▪ ,44]. Safety profiles were excellent, with no reported DAA-related serious adverse events, chemotherapy interruptions or significant toxicities due to drug interactions [25,40,41 ▪ ,42,43 ▪ ,44]. Similarly, multiple case series have reported 100% per-protocol SVR12 rates after various DAA-based regimens in children with thalassemia [34,37,45,46].…”

“…Early eradication of HCV is of paramount importance to prevent liver-related complications. Single patient case reports or case series of successful HCV treatment using DAA regimens have been reported in children with haematologic malignancies and those undergoing haematopoietic stem cell therapy [25,40,41…”