Observational studyJournal of the Pediatric Infectious Diseases Society2025
Pediatric and Adolescent Hepatitis C Care Cascade and Real-World Treatment Outcomes Utilizing an Integrated Health System Specialty Pharmacy Model.
Observational study in Journal of the Pediatric Infectious Diseases Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Hepatitis C Virus Testing in Perinatally Exposed Children.JAMA network open · 2026Article
- Successful Retreatment of Chronic Hepatitis C Virus Genotype 1A Infection With Glecaprevir/Pibrentasvir in a Pediatric Patient With Developmental Disorder.In vivo (Athens, Greece)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study evaluated the Cascade of Care (CoC) and real-world efficacy of direct-acting antivirals (DAAs) for hepatitis C treatment in pediatric and adolescent patients utilizing an integrated health system specialty pharmacy (HSSP) to assist with medication selection, insurance approval, swallowing practice, initiation, and monitoring.
methodsThis single-center, retrospective, observational cohort study included chronic hepatitis C patients <18 years old evaluated by pediatric hepatologists at an academic health system between January 1, 2017 and September 30, 2022. The primary endpoint was sustained virologic response (SVR) ≥12 weeks following treatment completion in patients initiating DAAs. Secondary endpoints were CoC advancement, variables impacting DAA initiation, patient-reported side effects, and adherence. An ordinal logistic regression model assessed whether initiation time was associated with a patient's ability to swallow, prior authorization outcome, and medication availability to HSSP at referral. The odds ratio reflects the likelihood of a shift in time to initiation for a given group relative to its respective reference group.
resultsOf 98 patients evaluated by a hepatologist, 73 (75%) were referred to the HSSP. Loss to follow-up was the primary reason (88%; 22/25) for nonreferral, most commonly (73%; 16/22) in those aged ≤5 years. Following HSSP referral, 88% (64/73) initiated DAA and 92% (59/64) of those achieved SVR. Time from HSSP referral to medication initiation was impacted by DAA availability (OR = 41.47; 95% CI, 9.51-180.87; P <.001) and inability to swallow the dosage form at evaluation (OR = 3.94; 95% CI, 1.56-9.98; P =.004). Over half (53%; 34/64) of patients initiating DAA reported ≥1 adverse event; none discontinued treatment. Most (69%; 44/64) reported no missed doses.
conclusionsThe largest CoC drop-off occurred following initial clinic evaluation, primarily in children aged ≤5 years. Enhanced linkage to care efforts is needed in these patients. Conversely, nearly all patients referred to the HSSP were initiated on DAA, completed therapy, and achieved SVR.
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