Ledipasvir-Sofosbuvir for 12 Weeks in Children 3 to <6 Years Old With Chronic Hepatitis C

Kathleen B. Schwarz, Philip Rosenthal, Karen F. Murray, Jonathan R. Honegger, Winita Hardikar, Rosie Hague, Naveen Mittal, Benedetta Massetto, Diana M. Brainard, Chia Hsiang Hsueh, Jiang Shao, Bandita Parhy, Michael R. Narkewicz, Girish S. Rao, Suzanne Whitworth, Sanjay Bansal, William F. Balistreri

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


For children under 12 years of age who have chronic hepatitis C virus (HCV) infection, there are currently no approved treatments with direct-acting antiviral agents. We therefore evaluated the safety and efficacy of ledipasvir-sofosbuvir in HCV-infected children aged 3 to <6 years. In an open-label study, patients 3 to <6 years old chronically infected with HCV genotype 1 (n = 33) or 4 (n = 1) received weight-based doses of combined ledipasvir-sofosbuvir as granules (33.75 mg/150 mg for weights <17 kg or 45 mg/200 mg for weights ≥17 kg) for 12 weeks. The primary endpoint was sustained virological response 12 weeks after treatment (SVR12). For the first 14 patients, intensive pharmacokinetic sampling was done on day 10 of treatment. All patients had been infected through perinatal transmission and were treatment naïve. No patients had known cirrhosis. Ten patients (29%) weighed <17 kg. SVR12 was achieved in 97% of patients (33 of 34); the patient who did not achieve SVR12 was 3 years old and discontinued treatment after 5 days because of an adverse event “abnormal drug taste.” The most common adverse events were vomiting (24% of patients), cough (21%), and pyrexia (21%). No patients experienced a serious adverse event. Intensive pharmacokinetic analysis of 13 patients for whom data were evaluable confirmed that the doses selected were appropriate. Conclusion: Ledipasvir-sofosbuvir was well tolerated and highly effective in children 3 to <6 years old with chronic HCV infection.

Original languageEnglish (US)
Pages (from-to)422-430
Number of pages9
Issue number2
StatePublished - Feb 1 2020

ASJC Scopus subject areas

  • Hepatology


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