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Long term effect of alpha interferon in children with chronic hepatitis B

F Bortolotti1, P Jara, C Barbera

  • 1Clinica Medica 5, University of Padua, Italy.

Gut
|April 15, 2000
PubMed

Insights

Interferon alpha (IFN) treatment for chronic hepatitis B in children did not improve long-term HBeAg clearance rates compared to controls. However, IFN accelerated HBsAg loss in patients with active disease who responded early.

Area of Science:

  • Pediatric Hepatology
  • Viral Hepatitis Research
  • Immunomodulatory Therapy

Background:

  • Chronic hepatitis B (CHB) infection in children requires long-term management and prognosis assessment.
  • Interferon (IFN) alpha has been used to treat CHB, but its long-term impact on disease progression in pediatric populations needs further definition.

Purpose of the Study:

  • To define the long-term prognosis of chronic hepatitis B infection in children treated with interferon alpha.
  • To evaluate the sustained efficacy of IFN alpha in pediatric CHB patients.

Main Methods:

  • A cohort of 107 children with CHB received IFN alpha for 3-6 months and were followed for a mean of 69 months.
  • Treatment response was defined by hepatitis B e antigen (HBeAg) loss within 12 months post-treatment.
  • A control group of 59 untreated children was followed for a mean of 46 months.

Main Results:

  • Sustained HBeAg clearance rates at five years were similar between IFN-treated children (60%) and controls (65%).
  • High baseline transaminases and histological activity index predicted treatment response.
  • Hepatitis B surface antigen (HBsAg) loss occurred in 25% of early responders treated with IFN, but not in non-responders or controls.

Conclusions:

  • IFN alpha treatment in children with CHB appears to accelerate spontaneous HBeAg clearance rather than increase the overall rate.
  • IFN alpha significantly enhanced HBsAg loss in children with active disease who responded early, suggesting a specific benefit for this subgroup.
Abstract

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