Aim of the study

The advent of direct-acting antivirals (DAAs) has fundamentally changed the management of hepatitis C virus (HCV) infection, making treatment highly effective and well tolerated, including in paediatric patients. The aim of this study was to evaluate the clinical features, routes of transmission, social factors, and diagnostic approaches in children with chronic hepatitis C, and to highlight the challenges of timely diagnosis and management in real-world clinical practice.

Material and methods

We performed a retrospective cohort study of 16 children (7 boys and 9 girls) aged 3-18 years, treated with DAAs for chronic hepatitis C between 2019 and 2025 at a tertiary care centre in the Czech Republic. Clinical characteristics, treatment regimens, virologic outcomes, safety and social outcomes were analysed.

Results

Twelve patients received glecaprevir/pibrentasvir for 8 weeks, and four received sofosbuvir/velpatasvir for 12 weeks. Genotypes included 1a, 1b, 3, and 1b/2. Most patients had minimal fibrosis (F0-F1). Sustained virological response at 12 weeks after treatment was achieved in 100% of patients. No serious adverse events or treatment discontinuations occurred. A substantial proportion of children were in foster or institutional care.

Conclusions

In the DAA era, paediatric HCV infection is a highly curable condition, with excellent safety outcomes.