Long-term Outcomes of Ledipasvir/sofosbuvir Treatment of Chronic Hepatitis C in Four Teenagers With Significant Liver Fibrosis

Long-term outcomes of therapy with ledipasvir/sofosbuvir (LDV/SOF) in children with chronic hepatitis C (CHC) and significant liver fibrosis were evaluated. Among 35 patients aged 12-17 years treated with LDV/SOF, there were four participants with significant fibrosis: one with a fibrosis score of F2 in the METAVIR scale, and three with cirrhosis (F4) evaluated with transient elastography (TE) at baseline. Patients were followed every 4 weeks during the treatment, at the end of the therapy, week 12 posttreatment, and one year after the end of treatment. One year after the end of treatment, the hepatitis C viral load was undetectable in three patients. In 2/4 patients, a significant regression of liver fibrosis was observed (from stage F4 and F2 to F0-F1 in the METAVIR scale). In one patient, the liver stiffness measurement median increased 12 weeks after the end of the treatment and then decreased but still correlated with stage F4. One patient was lost to follow-up after week 4. A one-year observation of teenagers with CHC and significant fibrosis treated with LDV/SOF revealed that regression of liver fibrosis is possible, but not obligatory. Further observations in larger groups of patients are necessary to find predictors of liver fibrosis regression.