Pharmacokinetics, Safety, Efficacy and Acceptability of Daclatasvir Plus Sofosbuvir in HCV-infected Children

This is an interventional, single center, single arm clinical trial to assess the pharmacokinetics, safety, efficacy, and acceptability of daclatasvir plus sofosbuvir in treatment-naïve children weighing between 14 and 35 kg with chronic HCV GT 1-6 infection.

This is an interventional, single center, single arm clinical trial to assess the pharmacokinetics, safety, efficacy, and acceptability of daclatasvir plus sofosbuvir in treatment-naïve, children weighing between 14 and 35 kg with chronic HCV GT 1-6 infection.

All enrolled patients will receive daclatasvir 30 mg orally once daily plus sofosbuvir at a dose of 200 mg (2x 100 mg tablets) orally once daily for 12 weeks.

Patients will be followed closely for disease progression and any hypersensitivity or adverse reactions due to therapy. Laboratory values to be monitored at baseline are serum creatinine, bilirubin, Aspartate transaminase (AST), Alanine transaminase (ALT), viral load (VL).

patients will be recruited in each of two weight bands (14 to \< 17 kg and 17 to 35 kg). The study is mainly powered for non-compartmental pharmacokinetics determination of DCV, SOF and GS-331007. Patient recruitment will be done at Ain Shams university hospitals, Egypt. The study be will conducted after approval by the corresponding research ethical committee and obtaining an informed consent from the parents or the legal guardians, and -whenever applicable- an assent from the patients.

Total number of visits is 7 for patients who will complete the study, a screening visits, at the first day of therapy, at weeks 1, 4, 8, 12 and 24 after starting daclatasvir plus sofosbuvir. Patients who will complete their treatment schedule will come after 12 weeks for assessment of SVR. Duration of follow up will be 6 months from treatment initiation in addition to screening period (2-4 weeks).

Eligibility Criteria:
Inclusion Criteria:

* Children more than 3 years of age and weighing 14-35kg
* Infected with HCV genotypes 1-6
* Treatment Naïve HCV-infected children
* Signing a written consent form by the parent or the legal guardian, and -whenever applicable- an assent by the patient
* Screening laboratory values within predefined thresholds:

  1. Absolute neutrophil count ≥ 1,500/mm3
  2. Platelets \> 50,000 cells/mm3
  3. Albumin \> 3.5 mg/dL
  4. Prothrombin Time PT \< 4 sec above control Or International Normalized Ratio INR \<1.7 3
  5. Random blood glucose level within normal range (\> 70 mg/dL and \< 200 mg/dL)
  6. Serum creatinine \< 1.5 mg/dL

Exclusion Criteria:

* Co-infection with HIV, acute hepatitis A virus, or hepatitis B virus
* Clinical hepatic decompensation, i.e., Child-Turcotte-Pugh CTP class B or C (i.e., jaundice, ascites, encephalopathy, or variceal hemorrhage)
* Renal dysfunction, i.e., eGFR \< 60 mL/min/1.73 m2 or on regular dialysis as calculated by Schwartz Formula
* Alfa-fetoprotein level \> 50 ng/mL
* Chronic liver disease due to a cause other than HCV or Known hypersensitivity to daclatasvir or sofosbuvir.
* History of gastrointestinal disease or gastrointestinal surgical procedure that would impair the absorption of the study drug
* Blood/blood product transfusion within 4 weeks prior to study.
* Systemic corticosteroid administration for more than 2 weeks starting from two weeks before study inclusion and till the end of treatment period (pulmonary/nasal administration is permitted).
* Psychiatric hospitalization, suicide attempt or disability resulting from psychiatric illness within the prior 5 years.
* Ongoing treatment with any medications interacting with daclatasvir/sofosbuvir.