Table 2.

Suggested management plan in children with genotypes '2 and 3'

HCV RNA Assay	Recommendation as per the HCV RNA assay result
Week 4 qualitative HCV RNA assay*
Negative assay (<50 lU/mL), i.e., a case of RVR	Institute a standard treatment course of 24 weeks. Although, a few studies have shown attainment of comparable SVR rates in this subgroup with shortened treatment courses of 12-16 weeks, more data is needed to validate this recommendation in pediatric age group
Positive assay	Give treatment for the standard duration of 24 weeks† (may be 36-48 weeks)
Week 24 qualitative HCV RNA assay
Negative assay, i.e., a case of ETR	Successful therapy. Needs a repeat qualitative HCV RNA assay at week 48 (24 weeks after ETR) to establish SVR
Positive assay	Treatment failed
Week 48 qualitative HCV RNA assay
Negative assay, i.e., a case of SVR	HCV infection got eradicated

^*The newly recommended week-4 qualitative HCV RNA assay helps modify the duration of the therapy based on viral kinetics. On one hand, this approach helps maximize the SVR rates and on the other hand, limits the toxicities and cost associated with the extended treatment courses. Achievement of RVR means that we can consider shortening the treatment course

^†SVR rates achieved in this subgroup are relatively poor. Thus prolonged therapy (>24 weeks) may be considered in this subgroup, although more evidence is needed at this time for a definite recommendation