Poddar, UjjalReddy, DV Umesh2023-08-252023-08-252023-01Poddar Ujjal, Reddy DV Umesh. Management of Hepatitis C in Children – A New Paradigm. Indian Pediatrics. 2023 Jan; 60(1): 55-620079-60610974-7559http://imsear.searo.who.int/handle/123456789/225457Introduction: With the advent of direct-acting antivirals (DAAs), the past decade has seen a paradigm shift in the management of hepatitis C (HCV) infection in children. In this review, we summarize the various treatment options for pediatric HCV infection, highlighting the recent changes in the management. Methods: A literature search was performed using the PubMed database with the relevant keywords. Filters included were human, ages 0-18 years, and the English language. Results: Initial phase of HCV treatment using conventional or pegylated interferon and ribavirin combination regimens yielded poor outcomes in children, especially in genotypes 1 and 4, with an overall sustained virologic response of 58%. Also, treatment with interferon and ribavirin combination was associated with significant side effects in up to 52% of those treated. Presently, various combinations of direct-acting antivirals (DAAs) have been approved in children above three years of age with documented evidence of high efficacy (SVR12 of 92% to 100%) and excellent safety, and the current standard of care. Conclusion: With various DAA regimens now being approved for children above three years of age, the treatment of active HCV infection (HCV-RNA positive) in children has become simple. Besides the effectiveness of DAA therapy, public awareness about HCV transmission, better screening, and making the DAAs available at a subsidized price in the public sectors are necessary to eliminate HCV infection in India.Direct-acting antiviralsInterferonOutcomeRibavirin.Journal ArticleIndiaDepartments of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar PradeshDepartment of Pediatric Gastroenterology, Post Graduate Institute of Child Health Hospital, Noida, Uttar Pradesh.