The results of 2 reported case studies of children with chronic hepatitis C infection indicated that viral eradication can be achieved and maintained until full immune recovery throughout allogeneic hematopoietic stem cell transplantation, if the patients receive full courses of direct-acting antivirals (DAAs) immediately before undergoing the procedure, according to a study published in the Journal of Viral Hepatitis.
American Society for Blood and Marrow Transplantation guidelines currently recommend that hematopoietic stem cell transplantation candidates with hepatitis C start and complete DAA therapy prior to undergoing stem cell transplantation. Time constraints and limiting comorbidities, treatments, and conditions can often make this approach unfeasible, but data on antiviral treatment safety and efficacy and the late effects of hepatitis C infection in hematopoietic stem cell transplantation patients are unknown.
This article reports on the cases of 2 children with chronic hepatitis C infection. Patient 1 successfully completed 12 weeks sofosbuvir/ribavirin therapy 6 days prior to undergoing hematopoietic stem cell transplantation for bone marrow failure. Post-transplant, the patient was given cyclosporine A, methotrexate, valaciclovir, and liposomal amphotericin B.