Transition From Interferon-Based Therapy to Direct-Acting Antivirals in Albanian Children With Chronic Hepatitis C: A 17-Year Real-World Experience.

Background: Direct-acting antivirals (DAAs) have transformed the management of chronic hepatitis C virus (HCV) infection, including in children. However, real-world data from resource-limited settings remain scarce. Methods: We conducted a retrospective study of children with chronic HCV infection treated at the national pediatric hepatology center in Tirana, Albania, between 2007 and 2024. Patients were grouped according to treatment era: interferon-based therapy or DAA regimens. Sustained virologic response (SVR), adverse events, and treatment duration were assessed. Results: Twenty-nine children were included (17 interferon era; 12 DAA era). SVR was achieved in 83% of patients receiving interferon-based therapy and in all patients treated with DAAs. Adverse events were more frequent and clinically significant in the interferon group, whereas only mild events were observed in the DAA group. Treatment duration was substantially shorter with DAAs (8-12 weeks vs. 48 weeks). Conclusions: This real-world experience reflects the transition toward shorter, better-tolerated, and highly effective therapies for pediatric HCV infection. While cross-era comparisons are limited, the findings are consistent with the established efficacy of DAA regimens.