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A longitudinal study of the efficacy of interferon therapy in children with chronic hepatitis B
Irma Kacprzak-Bergman1, Izabela Zaleska, Jarosław Gruszka
1Department of Pediatric Infectious Diseases, Medical University, Wrocław, Poland. irmberg@zak.am.wroc.pl
Insights
Interferon alpha (IFN) therapy effectively treats chronic hepatitis B in children, with higher efficacy observed in girls over a 28-month follow-up. The treatment showed a positive correlation with seroconversion and a transient impact on blood counts.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Virology
Background:
- Chronic hepatitis B is a significant global health concern.
- Interferon alpha (IFN) is a primary therapeutic agent for chronic hepatitis B.
- Understanding IFN efficacy in pediatric populations is crucial for treatment optimization.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of Interferon alpha (IFN) therapy in children with chronic hepatitis B.
- To assess the correlation between IFN dosage, serological markers, and clinical outcomes.
- To investigate gender-specific differences in treatment response.
Main Methods:
- A cohort of 193 Caucasian children (aged 1.5-17 years) received IFN therapy (3.0 MIU thrice weekly for 20 weeks).
- Patients were monitored over a 28-month period, including baseline, post-treatment, and extended follow-up intervals.
- Key parameters assessed included hepatitis B e-antigen (HBeAg), hepatitis B surface antigen (HBsAg) elimination, antibody presence (HBeAb, HBsAb), and alanine aminotransferase (ALT) levels.
Main Results:
- Hepatitis B core antigen (HBcAg) elimination rates increased progressively, reaching 63.9% by 24 months, with significantly higher rates in girls.
- Positive correlations were observed between IFN dosage and HBeAg/HBsAg elimination and HBeAb/HBsAb presence.
- ALT levels decreased significantly, particularly in girls, and IFN therapy transiently reduced hemoglobin, leukocytes, and thrombocytes, especially in boys.
Conclusions:
- IFN therapy demonstrates sustained efficacy in pediatric chronic hepatitis B, with enhanced outcomes in girls over extended follow-up.
- A clear relationship exists between IFN dose and serological marker seroconversion (HBeAg/HbeAb and HBsAg/HBsAb).
- IFN exerts a transient, manageable negative effect on peripheral blood counts.
Background:
Interferon alpha (IFN) is the most effective drug in the treatment of chronic hepatitis B. This article presents the results of IFN therapy and 28-month follow-up.
Material/Methods:
193 Caucasian children (130 boys and 63 girls) aged 1.5-17 years were treated with IFN for 20 weeks (3.0 MIU 3 times a week). They were examined at baseline (period 0), after 6 weeks (period 1), 12 weeks (period 2), 20 weeks (period 3), 6 months (period 4), 12 months (period 5), 18 months (period 6), and 24 months (period 7).
Results:
HBcAg elimination drom period 3 was: 29.6%, 35.2%, 45.4%, 58.3%, in period 7 63.9% (significantly higher in girls). Significant positive correlations were found in several periods between IFN/m2 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence and negatie correlations between IFN/m2 and ALT activity. ALT activity significantly decreased in girls between periods 0-3, in boys between 0-3 and 4-6. Significant positive correlations between ALT-0 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence was seen in several periods, more frequently in girls. IFN transiently decreased Hb, leukocytes, and thrombocytes, especially in boys. No relationship was found between IFN therapy and bilirubin, protein, albumin and gammaglobulin concentrations. The prothrombin index increased after 6 months of IFN therapy in girls.
Conclusions:
The efficacy of IFN therapy is clearer with longer observation, especially in girls. A relationship was found between IFN dose and HBeAg/HbeAb and HBsAg/HBsAb seroconversion. IFN had a transient negative effect on the peripheral blood picture.
