Pangenotypic Glecaprevir/Pibrentasvir Therapy for Chronic Hepatitis C in Children

The elimination of hepatitis C virus (HCV) infection as a public health threat is impossible to achieve without micro-elimination in children. Our study aimed to analyze the use of glecaprevir/pibrentasvir (GLE/PIB), one of the pangenotypic options recommended in children, which provides the shortest possible therapy duration.

All consecutive children treated with an 8-week GLE/PIB regimen for chronic HCV infection between 2022 and 2024, whose data were collected retrospectively, were included in the analysis.

The study population consisted of 42 patients with a median age of 10.5 years, mostly girls (61.9%), divided into age ranges of 3-5 years, 6-11 years and 12-18 years, comprising 6, 16 and 20 patients, respectively. Obesity was diagnosed only in the oldest group in as many as 25% of the children. Other comorbidities were present in 2 patients-kidney disease and bronchial asthma. All children were treatment-naive, and almost half of them (47.6%) were infected with genotype 1b. The advancement of liver disease by noninvasive elastography was assessed in 36 children, with half of them showing no fibrosis. Antiviral therapy was completed in all patients as planned, and the cure rate in the per-protocol population was 100% (39/39). Three girls were considered lost to follow-up. Adverse events were rare and mild, occurring only in the oldest group.

Eight-week GLE/PIB therapy in children is well tolerated and highly effective in all age ranges regardless of gender. Its use in routine clinical practice will bring the ambitious goal of eliminating HCV worldwide a step closer.