Safety and Efficacy of Ledipasvir/Sofosbuvir in the Treatment of Chronic Hepatitis C Virus Infection in Treatment-Naïve Children without and with Comorbidities.

BACKGROUND: Chronic hepatitis C virus (HCV) infection represents a crucial health problem in children that greatly influences their quality of life. Many efforts have been directed toward investing in effective drugs with a high safety profile and oral administration for better compliance. OBJECTIVES: This study aims to assess the safety of a fixed-dose combination of ledipasvir/sofosbuvir plus drug efficacy and sustained virologic response (SVR) at 12 weeks after treatment discontinuation. METHOD: One tablet (90 mg ledipasvir, 400 mg sofosbuvir) was administered to treatment-naïve children aged 12-18 years weighing at least 35 kg with chronic HCV infection for 6 months, genotype 4. Patients were divided into 2 groups, (1) without comorbidities (24 patients) and (2) with comorbidities (26 patients). RESULTS: At the end of the therapy, all patients (100%) had SVR and a significant reduction of liver enzymes with mild tolerable side effects. CONCLUSION: Ledipasvir/sofosbuvir fixed-dose combination is a safe and highly effective therapeutic option in Egyptian children aged ≥ 12 years, with chronic HCV infection, genotype 4, either without or with comorbidities.

Steroid Phobia among Parents of Asthmatic Children: Myths and Truth.

Asthma is one of the most common chronic diseases of childhood. Inhaled corticosteroids (ICS) are the recommended controller drug for asthma treatment. The aim of our study was to determine concerns and fears of parents of children with asthma towards the use of ICS. One hundred parents of asthmatic children were interviewed using structural questionnaire. Airway inflammation was reported by only 6% of interviewed parents, whereas airway narrowing was addressed by 34%. Interesting data, 71% of parents were concerned with the role of steroids in asthma treatment, but more than half (53%) of them addressed fears from side effects. Apparent gaps were found in knowledge of parents of asthmatic children about ICS as controller asthma medication. So, physician and health providers should explain to asthmatic parents that airway inflammation is the core for asthma management. This may remove fears about ICS and thus improve adherence to treatment.

Gene polymorphisms of IL-6(-174) G/C and IL-1Ra VNTR in asthmatic children.

OBJECTIVE: To check for the association of genetic polymorphisms of IL-6-(-174)G/C and IL-1RaVNTR with the susceptibility and severity of asthma in Egyptian children. METHODS: Subjects included 69 asthmatic children and 98 healthy unrelated controls from the Nile Delta of Egypt. Cases consisted of 20 males and 49 females with an age mean +/- SD is 7.5 +/- 2.1 ranging between 2-13 years. DNA amplification using PCR with sequence-specific primers was done for detection of promotor single nucleotide polymorphism of IL-6 gene as well as intron 2 VNTR of IL-1Ra gene. Frequency of case-genotypes or alleles were compared to controls using Fisher exact test and Odds ratio. RESULTS: Cases showed significant higher frequency of the genotypes: IL-6-174 GG (P<0.05, OR=3.2, 95% CI=1.09-10) that was evident mainly in the uncontrolled asthma subgroup indicative of the possibility of being a severity genotype. All cases as well as case-subgroups showed high significant frequency of IL-1Ra A1A1 (p<0.0001, OR=1.5, 95% CI=1.3-1.8). This may be considered a susceptibility genotype. Cases have also shown significant lower frequency of IL-6(-174) GC and IL-1Ra A1A2 genotypes (P<0.001 and P<0.0001 respectively). CONCLUSION: IL-6 and IL-1Ra polymorphisms can be considered genetic markers for bronchial asthma susceptibility and/or severity among Egyptian children. This may have a potential impact on family counseling and management.