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New treatments for chronic hepatitis C: an overview for paediatricians

Daniele Serranti1, Giuseppe Indolfi1, Massimo Resti1

  • 1Daniele Serranti, Department of Health Sciences, University of Florence, I-50139 Firenze, Italy.

World Journal of Gastroenterology
|December 5, 2014
PubMed

Insights

Current standard treatment for pediatric chronic hepatitis C involves pegylated interferon and ribavirin. New direct-acting antiviral agents offer potential for improved, targeted therapies in children.

Area of Science:

  • Hepatology and Virology
  • Pediatric Infectious Diseases
  • Pharmacology and Drug Development

Background:

  • Current standard treatment for pediatric chronic hepatitis C (HCV) utilizes pegylated interferon (IFN) α-2a or 2b combined with ribavirin, adapted from adult protocols.
  • Direct-acting antiviral agents (DAAs) represent a new class of drugs targeting specific steps in the HCV lifecycle, offering alternative treatment strategies.

Purpose of the Study:

  • To review the current landscape of chronic hepatitis C treatment in children.
  • To explore the development and potential of direct-acting antiviral agents (DAAs) for pediatric HCV infection.
  • To highlight the need for new, safe, and effective treatment regimens tailored for pediatric populations.

Main Methods:

  • Review of existing literature on pediatric chronic hepatitis C treatment regimens.
  • Analysis of the classification and mechanisms of action of various direct-acting antiviral agents (DAAs).
  • Discussion of emerging therapeutic compounds and future drug combinations for HCV.

Main Results:

  • Pegylated interferon and ribavirin remain the standard of care for children aged 3 and older.
  • DAAs, including HCV NS3/4A protease inhibitors, NS5B polymerase inhibitors, and NS5A inhibitors, are under development.
  • Other promising agents include cyclophilin A inhibitors, mi-RNA122, and interferon-lambda (IFN-λ).

Conclusions:

  • The evolution of DAAs and novel drug combinations presents opportunities for future pediatric HCV therapies.
  • Developing targeted regimens for children requires careful consideration of potency, resistance barriers, and safety profiles.
  • Future research will focus on creating IFN-free and tailored DAA-based regimens suitable for pediatric use.

Keywords:
ChildrenDaclatasvirEfficacyHepatitis C virusInterferonRibavirinSafetySofosbuvirTreatment

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