Successful treatment of vertically acquired Hepatitis C in a child using direct-acting antiviral therapy administered via gastrojejunal tube: A case report.

Hepatitis C virus (HCV) remains a significant global health burden, with vertical transmission being the primary route of infection in children. Direct-acting antivirals (DAAs) have transformed HCV treatment in pediatrics, but limited data exist on their administration in medically complex children who are dependent on enteral tubes. We report the case of a medically complex child with vertically acquired HCV who achieved sustained virologic response at 12 weeks (SVR12) following treatment with crushed sofosbuvir/velpatasvir (SOF/VEL) administered to a patient with a gastrojejunal tube. She was ineligible for oral therapy due to feeding difficulties but was granted insurance approval for off-label enteral administration. The patient completed a 12-week SOF/VEL regimen and achieved SVR12. This case supports the feasibility and effectiveness of enteral DAA administration using crushed SOF/VEL in children with complex medical needs. Further research and formal guidance are needed to optimize treatment strategies for pediatric patients with similar challenges.