Treatment of hepatitis C virus infection in children and adolescents

DAA: direct-acting antiviral agent for hepatitis C virus; HBV: hepatitis B virus; HCV: hepatitis C virus; HIV: human immunodeficiency virus.

* Patients with these characteristics require special considerations for regimen selection, treatment duration, and monitoring.

¶ The goal of deferring treatment is to wait until the patient has access to an effective regimen of DAAs that does not include ribavirin. These may become available by waiting until the patient reaches the age at which an effective DAA regimen is approved or by waiting until new regimens are approved for the patient's age group. Deferring treatment for even several years is often appropriate because most pediatric patients have mild HCV liver disease that progresses slowly.

Δ Each of these regimens is safe and effective; the choice depends on the patient's genotype (as noted) and on local approvals and availability. Ledipasvir-sofosbuvir is also effective for genotypes 1, 4, 5, and 6 but is rarely used if a pangenotypic regimen is available.