. 2021 Jan 15;3(2):100227. doi: 10.1016/j.jhepr.2021.100227

Table 2.

Comparison of international guidelines for screening and treatment of chronic HCV infection during pregnancy and in children and adolescents. Treatment.

Guideline and year of publication	Treatment in pregnancy	Children and adolescents: who to treat?	Children and adolescents: drug regimens recommended
American Association for the Study of Liver Diseases (AASLD) 2020²⁶	Treatment during pregnancy is not recommended owing to the lack of safety and efficacy data. For women of reproductive age with known HCV infection, DAAs recommended before considering pregnancy, whenever practical and feasible, to reduce the risk of HCV transmission to future offspring.	Treatment is recommended for all children ≥3 years old because they will benefit from antiviral therapy regardless of disease severity.	GT 1 and GT 4–6: weight-based sofosbuvir (SOF) and ledipasvir (LED) for children aged ≥3 years. GT 1–6: weight-based SOF and velpatasvir (VEL) for children aged ≥6 years or weighing ≥17 kg. GT 1–6: glecaprevir (GLE) (300 mg) and pibrentasvir (PIB) (120 mg) for adolescents aged ≥12 years or weighing ≥45 kg.
European Association for the Study of the Liver (EASL) 2018²⁷	HCV treatment during pregnancy is not recommended in the absence of safety and efficacy data. However, treatment can be considered during pregnancy, or in the case of accidental conception during treatment, on a case-by-case basis. Treatment regimens for use in pregnancy not specified.	Treatment is recommended for all children ≥3 years.	GT 1–6: fixed-dose combination of SOF (400 mg) and VEL (100 mg) or fixed-dose combination of GLE (300 mg) and PIB (120 mg) for adolescents aged ≥12 years who are treatment-naive or treatment-experienced and without cirrhosis or with compensated (Child-Pugh A) cirrhosis. GT 1–6: weight-based, fixed-dose combination of SOF/VEL or GLE/PIB for children aged 3–11 years (some formulations pending approval).
European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2018²⁸	No recommendation.	All treatment-naive and treatment-experienced children with chronic HCV infection should be considered for therapy. Treatment can generally be deferred in younger age groups for which combined peginterferon and ribavirin is the only treatment option currently available.	GT 1 and 4: children >12 years old or who weigh >35 kg should be given a combination of SOF (400 mg) and LED (90 mg) in a single tablet administered once a day for 12 weeks; recommended duration of therapy for treatment-experienced children with GT 1 infection and compensated cirrhosis is 24 weeks. GT 2: children >12 years old or who weigh >35 kg should be given SOF (400 mg) once a day plus weight-based RBV (15 mg/kg in 2 divided doses) for 12 weeks. GT 3: children >12 years old or who weigh >35 kg should be given SOF (400 mg) once a day plus weight-based RBV (15 mg/kg in two divided doses) for 24 weeks.
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) 2020³¹	No recommendation.	Treatment is recommended for all children >3 years old.	Currently approved and anticipated DAA regimens (details not specified).
World Health Organization (WHO) 201830,44	Treatment is not recommended during pregnancy.	Treatment should be offered to all individuals diagnosed with HCV infection who are ≥12 years old, irrespective of disease stage.	GT 1 and 4–6: SOF (400 mg) and LED (90 mg) for 12 weeks. GT 2: SOF (400 mg) plus weight-based RBV for 12 weeks. GT 3: SOF (400 mg) plus weight-based RBV for 24 weeks.

No recommendation: Asian Pacific Association for the Study of the Liver (APASL) 2016.

DAAs, direct-acting antivirals; GT, genotype.