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Sustained Viral Response in Genotype 4 Chronic Hepatitis C Virus–infected Children and Adolescents Treated With Sofosbuvir/Ledipasvir

El-Karaksy, Hanaa; Mogahed, Engy Adel; Abdullatif, Hala; Ghobrial, Carolyne; El-Raziky, Mona S.; El-Koofy, Nehal; El-Shabrawi, Mortada; Ghita, Haytham; Baroudy, Sherif; Okasha, Sawsan

Journal of Pediatric Gastroenterology and Nutrition: November 2018 - Volume 67 - Issue 5 - p 626–630
doi: 10.1097/MPG.0000000000002101
Original Article: Hepatology

Objectives: Recently, direct acting antivirals (DAAs), sofosbuvir (SOF) combined with ledipasvir (LED), were approved for treatment of hepatitis C virus (HCV)–infected children 12 years of age and older or weighting at least 35 kg for all HCV genotypes. The aim of this study was to assess the safety and efficacy of SOF/LED in genotype 4 HCV-infected Egyptian children and adolescents.

Methods: This observational study included 40 consecutive HCV-infected children of age 12 to <18 years old or weighing >35 kg, both treatment-naive and treatment-experienced. All of the children were hepatitis B virus–negative and had normal renal functions and heart rate. Patients received oral, fixed-dose combination tablet of SOF/LED (400 mg SOF, 90 mg LED [Harvoni]) once daily for 12 weeks. Potential side effects were recorded at weeks 4, 8, and 12 weeks of treatment. The study primary outcome was sustained virological response 12 weeks (SVR12) after end-of-treatment.

Results: The study included 40 children and adolescents, 24 were boys (60%); their age ranged between 11.5 and 17.5 years (mean 13.9 ± 1.5). Baseline viral load ranged between 9630 and 24,600,000 IU/mL. HCV RNA became negative in 39 patients (97.5%) at 4 weeks and in all patients (100%) at weeks 8, 12, and SVR12. Asthenia was the commonest side effect, reported in 52.5% followed by headache in 47.5%.

Conclusions: Treatment with all-oral DAAs (SOF/LED) for 12 weeks was well tolerated in Egyptian children and adolescents infected with genotype 4 HCV, with 100% SVR12 and negligible side effects.

Department of Pediatrics, Kasr Alainy Medical School, Cairo University, Cairo, Egypt.

Address correspondence and reprint requests to Engy Adel Mogahed, MD, 2B Sama City, Katamya, Cairo 11439, Egypt (e-mail:

Received 1 May, 2018

Accepted 7 July, 2018

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The authors report no conflicts of interest.

© 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,