Modern possibilities of antiviral therapy for chronic viral hepatitis C in children aged 3 to 17 in the Moscow Region

Aim to evaluate the effectiveness and safety of of glecaprevir/pibrentasvir (GLE/PIB) in two dosage forms and velpatosvir/sofosbuvir (VEL/SOF) in children 317 years old with chronic hepatitis C virus (HCV) in the Moscow region. Material and methods. We analyzed the results of treatment of 108 children over 3 years old with chronic hepatitis C who received in routine practice: GLE/PIB 50 mg/20 mg in granules (34 patients 3—12 years old) or GLE/PIB 300 mg/120 mg tablets (55 patients 12—17 years old) for a course of 8 weeks (with no experience in treating 88 children) and 16 weeks (with experience in treatment with interferon, 1 patient) or VEL/SOF 100 mg/400 mg tablets (19 patients 7—13 years old) for a course of 12 weeks. Results. In 62.3% of children with HCV were diagnosed with concomitant diseases (including cancer), in 35.2% liver disease, in 3.7% extrahepatic manifestations, in 22.2% a high viral load (106—107 IU / ml) and in 23.1% social burden. To ensure compliance, communication technologies were used (keeping patient diaries, weekly communication with the attending physician and patient reporting). The rate of sustained virological response 12 weeks after GLE/PIB or VEL/SOF (SVR12) did not depend on the dosage form of DAAs, age, viral load, concomitant diseases and in children with HCV GT1, GT2, GT4 and untyped GT was 100% (95% CI 94.5—100), GT3 97.6% (95% CI 87.7—99.6). Lack of effectiveness in one teenager with a socially burdened history was associated with irregular use of the drug. 24 weeks after the end of DAA, the incidence of liver fibrosis grade 1—2 according to the METAVIR scale decreased from 24.1% to 8.3% ( p < 0.001). Adverse events (25%) were mild, consistent with the seasonal disease spectrum (88.9%), and in most cases were not related to DAA use. In 2.8% of cases, when taking GLE/PIB, a temporary and asymptomatic increase in total bilirubin was recorded. Conclusion. The high efficacy and safety profile of the pangenotypic DAA regimens GLE/PIB (in two dosage forms) and VEL/SOF for the treatment of chronic hepatitis C in children 3 years of age and older has been proven using communication technologies and substantiates the possibility of a simplified regimen for the management of children with HCV.