Ribavirin free direct-acting antivirals in adolescents with hepatitis C and thalassemia
Background: Recently introduced antivirals (ribavirin free direct-acting antivirals) are now recommended in pediatric age group above 12 years of age but are not yet extensively studied in thalassemic patients with hepatitis C infection. This study aims to study the safety and efficacy of newer ribavirin-free direct acting antivirals in thalassemic children with hepatitis C.
Patients and Methods: All thalassemic patients with hepatitis C virus (HCV) infection fulfilling the inclusion criteria were recruited consecutively. Ribavirin free direct-acting antivirals (DAA) were started according to genotypes. Virological response was assessed at baseline, four, twelve and twenty-four weeks. Data regarding safety and efficacy of DAA in these children were collected and analyzed by SPSS.
Results: Twenty-one patients met the criteria for enrolment in the study. Sustained virological response (SVR) was seen in all patients (100%) at 24 weeks. Regarding adverse events in patients receiving daclatasavir plus sofosbuvir, nausea was seen in 33% followed by increased blood transfusion requirements in 22%, fatigue in 16%, headache in 11% and pancytopenia in one patient (5%). Patients receiving velpatasavir and sofosbuvir therapy, none of side effects were noted.
Conclusion: Ribavirin free DAAs are highly effective in thalassemic patients with hepatitis C and minimal adverse effects are observed especially in children receiving daclatasavir and sofosbuvir.