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Minerva Pediatrics 2022 February;74(1):23-30

DOI: 10.23736/S2724-5276.20.05881-8


language: English

Pegylated interferon and ribavirin gone but not forgotten in the era of direct-acting antivirals

Magdalena PLUTA 1, 2 , Maria POKORSKA-ŚPIEWAK 1, 2, Małgorzata ANISZEWSKA 1, 2, Zbigniew LEWANDOWSKI 3, Barbara KOWALIK-MIKOŁAJEWSKA 1, 2, Magdalena MARCZYŃSKA 1, 2

1 Department of Children’s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland; 2 Hospital of Infectious Diseases, Warsaw, Poland; 3 Department of Epidemiology, Medical University of Warsaw, Warsaw, Poland

BACKGROUND: Therapy with pegylated interferon and ribavirin (PEG-IFN+RBV) for chronic hepatitis C (CHC) remains the only option available for children in many Eurasian and European countries. Our aim was to evaluate the influence of host and viral factors on response to IFN-based therapy to optimize it for those in whom directly acting antivirals (DAA) are currently unavailable.
METHODS: Seventeen vertically infected, treatment naive children (10 male and 7 female) aged 5-16 years with CHC underwent a course of PEG-IFN+RBV. The end point was sustained virologic response (SVR). Host and virus factors were divided into pre- and on-treatment predictors of response to therapy.
RESULTS: Eleven patients obtained SVR (64%), 4 were non-responders (23%), and 2 were relapsers (12%). Significant relationship was found between HCV RNA elimination and following variables: virus genotype and early virologic response (EVR) (P<0.037, P<0.029 respectively). Higher eradication rate was observed in patients infected with genotype 3 HCV (100% vs. 65% with genotype 1 or 4), and in those with undetectable HCV RNA by week 12 (88% vs. 66% with viremia). EVR was associated with SVR (83% vs. 0% in nonresponders; P<0.004). C allele of IL28B rs12979860 was a predictor of EVR (P<0.043). The SVR rates among CC, CT, and TT carriers were as follows: 75%, 67%, and 33%.
CONCLUSIONS: Detection of favorable HCV and IL28B genotype prior to commencement of PEG-IFN+RBV and continuing it in patients with EVR is of major importance for those in whom DAA are still unavailable.

KEY WORDS: Hepatitis C, chronic; Interferons; Child

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