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DOES DIRECTLY ACTING ANTIVIRAL DRUG THERAPY FOR CHRONIC HCV INFECTION AFFECT THE REMISSION IN SURVIVORS OF CHILDHOOD MALIGNANCY?
Abstract
Background
The effects of the direct-acting antiviral drug therapy (DAA) for chronic hepatitis C on infected survivors of childhood cancer have not been well investigated in pediatric age groups.
Aims
We conducted a prospective multicenter study to investigate the effect of dual sofosbuvir/daclatasvir therapy on both the HCV clearance and state of cancer remission in survivors of childhood cancer infected with chronic HCV.
Methods
Consecutive chronic HCV-infected survivors of childhood malignancy were included in the study. All were treated with SOF/DCV for 12 weeks and were closely monitored for virus load, liver and kidney functions, and hematologic indices. Follow-up was continued for 48 weeks and included clinical examination, imaging studies, and laboratory investigations for evidence of any recurrence or de novo occurrence of malignant disease.
Results
A total of 49 chronic HCV infected pediatric patients were included; 29 survivors of malignant solid tumors, and 20 survivors of hematologic malignancies (leukemia/lymphoma). Their age ranged from 6 to 17 years (mean ± SD = 10.5 ± 3). All patients achieved SVR12 (100% ITT). No single relapse or recurrence was detected for the original malignant disease or the HCV infection. No de novo occurrence of malignancy was also observed throughout the follow-up period of 48 weeks.
Conclusions
SOF/DCV combined therapy might be used safely and effectively in the treatment of chronic HCV infected survivors of solid tumors or hematologic malignancy (leukemia/lymphoma) in pediatric age groups. No relapses were detected during treatment and throughout the follow up period for either the original malignant disease or the HCV infection.