Experience of using a direct-acting antiviral drug in children with chronic hepatitis C in the Moscow region

Russia ranks among the first countries both in Europe and around the world in terms of the number of children infected with the hepatitis C virus, which determines the medical and social importance of this problem for domestic healthcare. 
The aim of the study was to evaluate the clinical and laboratory features of the course and effectiveness of direct antiviral therapy of HCV in children and adolescents living in the Moscow region. 
Materials and methods. 28 children (13 boys and 15 girls) aged 3—16 years with HCV were under observation. The genotype of the pathogen was determined for all children before the start of antiviral therapy, and before and after completing an 8-week course of treatment with the direct antiviral drug glecaprevir+pibrentasvir, the viral load was determined by PCR, IgM and IgG antibodies to HCV by ELISA, clinical and biochemical blood tests, coagulogram, ultrasound of the abdominal organs and fibroelastography were performed. the liver. 
Results. Chronic hepatitis C (HCV) is detected mainly in school-age children (in 67.9%), in 60.7% of patients it is combined with other various pathologies. Infection occurs in 89.3% of cases during perinatal contact with a mother with HCV. The clinical picture is characterized by low symptoms, asthenia prevails (weakness — 35.8%, decreased appetite — 32.1%, headache — 7.2%, dizziness — 3.6%, drowsiness — 3.6%) and impaired motor function of the gastrointestinal tract (17.9%). Cytolysis syndrome is slightly pronounced, it is noted in 39.3—42.9% of children. Genotypes 1b (32.1%), 3a (25%) and 1a (17.9%) predominate. According to ultrasound data, hepatomegaly is observed in 28.6% of children, fibrosis grade F1 on the METAVIR scale is formed in 39.3% of patients. Antiviral therapy provides a stable virological response in 100% of cases and contributes to the normalization of biochemical parameters, as well as regression of fibrosis in all children treated with glecaprevir+pibrentasvir for 8 weeks. 
Conclusion. Currently, the most effective method for the further spread of hepatitis C is the early detection and treatment of children and adolescents suffering from this infection using direct antiviral agents.

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