The REACH Consortium has just published the results of a multi-centre survey, aimed at assessing the uptake of Direct-acting antivirals (DAAs) for the treatment of HCV in children and adolescents living in Russia. The article is available as Open access in the Journal of Virus Eradication.
DAAs, new drugs used to treat chronic HCV, have demonstrated high rates of cure with minimal toxicity when compared to interferon-based regimens. They have been available for adults in Russia since 2015 and in 2019 they were approved for treatment of HCV in adolescents aged 12 and older. Several regimens are now approved for use in paediatric patients as young as 3 years of age. But there are knowledge gaps about the uptake of DAAs and no age-specific measures available that explore DAA uptake among adolescents and children.
The REACH survey is the first study focusing on the uptake of DAA treatment for Russian children and adolescents with HCV. It was conducted in 268 clinics in 85 administrative regions of the Russian Federation in September 2020. The REACH researchers have been able to identify and document contemporary policies and practices across Russia on clinical and therapeutic management of children with HCV, including pre-treatment monitoring strategies. Since DAAs were registered in Russia for treating adolescents in 2019 and recommended in the subsequent national paediatric HCV treatment guidelines, only 15% of adolescents in follow-up have received treatment.
Although the rollout of DAA in Russia is in the early stages, the uptake baseline established by the REACH Consortium is an essential step for the development of treatment guidelines and can inform the optimised use of DAAs, thereby improving the quality of life for patients and leading, in the long term, to the reduction of the burden of HCV.
The Russian Federation has the largest paediatric HCV disease burden in Europe with an estimated 118,000 children living with the disease. It is expected that by 2030, the prevalence of HCV in Russia could rise, emphasizing the importance of accelerating access to safe and effective treatments. Scaling-up of testing and treatment with the new drugs is a key strategic intervention set by WHO to achieve the treatment coverage targets for the elimination of viral hepatitis as a public health threat by 2030. The inclusion of children and adolescents in strategies to achieve this goal is essential especially because the development of paediatric drugs lags behind the development of adult formulations.
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