Hepatitis C virus infection in children in the era of direct-acting antiviral.

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hepatitis C 15 infectiousdiseases
ribavirin 26 infectiousdiseasesdrugs
ritonavir 3 infectiousdiseasesdrugs
viral hepatitis 3 infectiousdiseases

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Select Drug Character Offset Drug Term Instance
ribavirin 9194 use of the fixed-dose combination of ledipasvir/sofosbuvir and of the combination of sofosbuvir and ribavirin for the treatment of adolescents with chronic hepatitis C virus (HCV) genotypes 1, 4, 5 and 6 and genotype
ribavirin 9550 licensed in Europe and the US for the treatment of chronic HCV infection in children include IFN, PEG IFN, ribavirin and, recently, the fixed-dose combination of ledipasvir/sofosbuvir and sofosbuvir for the treatment
ribavirin 9810 35 kg. The only drugs currently approved for children younger than 12 are PEG IFN α-2a or -2b and ribavirin . Children with HCV genotypes 1 or 4 infection should be treated for 48 wk whereas those infected with
ribavirin 10464 genotypeNCT 3067129Glecaprevir/pibrentasvir1-6NCT 2486406Ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin 1,4NCT 3080415Sofosbuvir + daclatasvir4NCT 2868242Ledipasvir/sofosbuvir1,4NCT 2249182Ledipasvir/sofosbuvir
ribavirin 10583 3080415Sofosbuvir + daclatasvir4NCT 2868242Ledipasvir/sofosbuvir1,4NCT 2249182Ledipasvir/sofosbuvir ± ribavirin 1,4,5,6NCT 3022981Sofosbuvir/velpatasvir1-6NCT 2985281Gratisovir + ribavirin1-6HCV: Hepatitis C virus.The
ribavirin 10659 2249182Ledipasvir/sofosbuvir ± ribavirin1,4,5,6NCT 3022981Sofosbuvir/velpatasvir1-6NCT 2985281Gratisovir + ribavirin 1-6HCV: Hepatitis C virus.The first study assessing the IFN-free treatment of HCV-infected adolescents
ribavirin 16170 to the population norms without HCV[[46]]. This was the first clinical trial of an interferon- and ribavirin -free regimen in children with HCV infection that showed not only a very high efficacy and a favourable
ribavirin 17292 uncontrolled registration trial, 52 patients were treated with sofosbuvir (400 mg) once daily and weight-based ribavirin (15 mg/kg) twice daily for 12 (genotype 2) or 24 (genotype 3) wk[[48]]. The pharmacokinetics of sofosbuvir
ribavirin 18031 SVR4. The most commonly reported adverse events were nausea (27%) and headache (23%). Sofosbuvir and ribavirin were safe and highly effective in adolescents with chronic HCV genotype 2 or 3 infections[[48]]. To
ribavirin 19160 assessed the effectiveness and safety of the combined administration of sofosbuvir (400 mg) once daily and ribavirin (10-15 mg/kg/d) in treatment-naïve children with HCV infection aged 5 to 18 years. The total therapy
ribavirin 20835 mg once daily) with dasabuvir (only for those with genotype 1 infection; 250 mg twice daily) and/or ribavirin (for all patients with genotype 1a or 4 infection; 15 mg/kg divided twice daily)[[52]]. All patients
ribavirin 21428 prospective, open-label, uncontrolled trial on combined therapy with sofosbuvir, daclatasvir with or without ribavirin (400 mg + 60 mg + 15 mg/kg) of 13 adolescents with HCV genotype 4 infection were presented. The SVR
ribavirin 22157 yr1ledipasvir 45 mg + sofosbuvir 200 mg1298Wirth et al[[48]]13 adolescents aged 12-17 yr2sofosbuvir 400 mg + ribavirin 15 mg/kg1210039 adolescents aged 12-17 yr3sofosbuvir 400 mg + ribavirin 15 mg/kg2497Hashmi et al [[50]]35
ribavirin 22229 12-17 yr2sofosbuvir 400 mg + ribavirin 15 mg/kg1210039 adolescents aged 12-17 yr3sofosbuvir 400 mg + ribavirin 15 mg/kg2497Hashmi et al [[50]]35 children aged 5-18 yr3,1sofosbuvir 400 mg + ribavirin 10-15 mg/kg2497Leung
ribavirin 22317 yr3sofosbuvir 400 mg + ribavirin 15 mg/kg2497Hashmi et al [[50]]35 children aged 5-18 yr3,1sofosbuvir 400 mg + ribavirin 10-15 mg/kg2497Leung et al [[52]]38 adolescents1,4ombitasvir 150 mg + paritaprevir 100 mg + ritonavir
ribavirin 22458 [[52]]38 adolescents1,4ombitasvir 150 mg + paritaprevir 100 mg + ritonavir 25 mg ± dasabuvir 250 mg ± ribavirin 12-24100El-Sayed et al [[53]]13/18 adolescents4sofosbuvir 400 mg + daclatasvir 60 mg ± ribavirin 15
ribavirin 22555 ± ribavirin12-24100El-Sayed et al [[53]]13/18 adolescents4sofosbuvir 400 mg + daclatasvir 60 mg ± ribavirin 15 mg/kg8-12100HCV: Hepatitis C virus; SVR: Sustained virologic response.RECOMMENDATIONS FOR THE TREATMENT
ribavirin 23952 15 IU/mL) 12 wk (SVR12) after the end of DAA treatment or 24 wk (SVR24) after the end of PEG IFN and ribavirin (A1).The rationale underlying the indications for treatment of adults with chronic infection is also
ribavirin 24784 immunosuppressive treatments) (A1).Treatment can generally be deferred in age-cohorts where combined PEG IFN and ribavirin is the only treatment option (C1).IFN-free regimens are the best options in HCV-infected adolescents
ribavirin 25013 age, weight > 35 kg), independent of the stage of liver disease and of co-morbidities (C1).PEG IFN and ribavirin have not been recommended for the treatment of HCV-infected adolescents since 2017 (C1).Treatment of
ribavirin 25759 infected with HCV genotype 2 should be treated with sofosbuvir (400 mg) once daily and weight-based ribavirin (15 mg/kg divided into 2 doses) for 12 wk (C1). And (2) Children older than 12 years who weigh > 35
ribavirin 25992 infected with HCV genotype 3 should be treated with sofosbuvir (400 mg) once daily and weight-based ribavirin (15 mg/kg divided into 2 doses) for 24 wk (C1) (Figure 1).Figure 1Recommended treatment of hepatitis
ribavirin 26233 HCV: Hepatitis C virus.Treatment of chronic HCV infection in children younger than 12 yearsPEG IFN and ribavirin are no longer recommended as a general treatment for children younger than 12 years who are infected
ribavirin 27111 that for adults. Long-term follow-up paediatric studies, with combined therapy with IFN or PEGIFN + ribavirin , have shown that SVR24 corresponds to a definitive cure of HCV infection in 98% to 100% of cases[[55],[56]].
ribavirin 27552 disease and of the presence or absence of co-morbidities. Consequently, the combination of PEG IFN and ribavirin is no longer recommended.NON-INVASIVE EVALUATION OF LIVER DISEASE SEVERITYThe clinical management of
ribavirin 41868 liver disease and the presence or absence of co-morbidities. Therefore, the combination of PEG IFN and ribavirin is no longer recommended. Chronic HCV infection is generally mild in children, but treatment should
ritonavir 10438 identifierDrug testedHCV genotypeNCT 3067129Glecaprevir/pibrentasvir1-6NCT 2486406Ombitasvir/paritaprevir/ ritonavir ± dasabuvir ± ribavirin1,4NCT 3080415Sofosbuvir + daclatasvir4NCT 2868242Ledipasvir/sofosbuvir1,4NCT
ritonavir 20713 adolescents with HCV genotype 1 or 4 infections were enrolled and treated with ombitasvir/paritaprevir/ ritonavir (150/100/25 mg once daily) with dasabuvir (only for those with genotype 1 infection; 250 mg twice daily)
ritonavir 22419 ribavirin 10-15 mg/kg2497Leung et al [[52]]38 adolescents1,4ombitasvir 150 mg + paritaprevir 100 mg + ritonavir 25 mg ± dasabuvir 250 mg ± ribavirin12-24100El-Sayed et al [[53]]13/18 adolescents4sofosbuvir 400
Select Disease Character Offset Disease Term Instance
hepatitis C 1736 evaluate the new therapies and non-invasive methods for liver injury in paediatric patients with chronic hepatitis C .Core tip: There are more than 11 million hepatitis C virus (HCV)-infected children worldwide. Most new
hepatitis C 1789 liver injury in paediatric patients with chronic hepatitis C.Core tip: There are more than 11 million hepatitis C virus (HCV)-infected children worldwide. Most new HCV-infected cases have occurred through vertical
hepatitis C 3676 and lower incidences are reported in countries with high incomes (0.05%-0.36%)[[9]].The prevalence of hepatitis C antibodies in adults in North America is estimated at 1% to 1.5%[[10]], whereas it is estimated at 0.8%
hepatitis C 8570 substance use amongst children with HCV increased from 25% in 2006 to 41% in 2012[[33]]. Screening for hepatitis C should be considered for those children with risk factors for HCV and for pregnant women.DIRECT-ACTING
hepatitis C 8965 Currently, highly effective, safe and well-tolerated antiviral regimens are available to treat adults with hepatitis C infection[[34]].In 2017, the European Medicines Agency (EMA) and the Food and Drug Administration (FDA)
hepatitis C 9250 ledipasvir/sofosbuvir and of the combination of sofosbuvir and ribavirin for the treatment of adolescents with chronic hepatitis C virus (HCV) genotypes 1, 4, 5 and 6 and genotype 2 and 3 infections, respectively. Trials with direct
hepatitis C 10315 clinical trials to evaluate the safety and efficacy of direct-acting antivirals in children with chronic hepatitis C Trial identifierDrug testedHCV genotypeNCT 3067129Glecaprevir/pibrentasvir1-6NCT 2486406Ombitasvir/paritaprevir/ritonavir
hepatitis C 21792 infected children was presented in Table 2.Table 2Efficacy of direct-acting antivirals treatment of hepatitis C virus infected children and adolescentsStudyPatient populationHCV genotypeDrugDuration of therapy (wk)SVR
hepatitis C 26093 ribavirin (15 mg/kg divided into 2 doses) for 24 wk (C1) (Figure 1).Figure 1Recommended treatment of hepatitis C virus infected children. HCV: Hepatitis C virus.Treatment of chronic HCV infection in children younger
hepatitis C 27685 recommended.NON-INVASIVE EVALUATION OF LIVER DISEASE SEVERITYThe clinical management of children with chronic hepatitis C (CHC) remains under discussion. Prognosis, risk stratification and treatment decision depend on histological
hepatitis C 34600 liver cirrhosis becomes more important as a screening tool in all paediatric patients with chronic hepatitis C , which would allow many patients to avoid biopsy.PHYSICAL TECHNIQUESThe rise in popularity of minimally
hepatitis C 36166 obese[[77]]. The accuracy of TE has been shown to be excellent in several studies of adults with chronic hepatitis C [[74],[78]-[81]]. Overall, the published studies on children and adolescents that have compared different
hepatitis C 36608 the utility of TE (FibroScan) in liver fibrosis using the METAVIER score in a cohort of 30 chronic hepatitis C patients is from Egypt by Awad et al[[82]]. They found that the highest predictive performance of TE
hepatitis C 41459 adolescents with a history of intravenous drug use and child victims of sexual assault. Screening for hepatitis C should be considered for children with risk factors for HCV and for pregnant women. The availability
hepatitis C 42071 should be an integral part of the public health approach necessary to succeed in the elimination of hepatitis C . The early identification of fibrosis in children may play a significant role in preventing the development
viral hepatitis 4663 trauma wards, respectively, together with health care workers and patients with diseases other than viral hepatitis [[14]]. In 2014, the world’s highest incidence of anti-HCV antibodies was recorded in Egypt at 14.7%[[15]].Geographic
viral hepatitis 33020 FibroTest-ActiTest was poorly correlated with the histopathological evaluation in paediatric patients with chronic viral hepatitis . We are constantly searching for new, more specific markers of liver fibrosis. A single study conducted
viral hepatitis 37364 disease, autoimmune hepatitis or liver transplantation recipients, and finally patients with chronic viral hepatitis [[66],[83]-[93]]. In 2 available studies amongst children with miscellaneous paediatric CLD including

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