Related Experiment Videos
Treatment with interferon gamma versus interferons alfa and gamma in children with chronic hepatitis B
M Ruiz-Moreno1, M J Rúa, G Moraleda
1Department of Pediatrics, Fundación Jiménez Díaz, Madrid, Spain.
Insights
Interferon gamma showed limited antiviral effects for children with chronic hepatitis B, with no significant difference in hepatitis B e antigen loss compared to untreated groups. The treatment was well-tolerated.
Area of Science:
- Hepatology
- Virology
- Pediatric Gastroenterology
Background:
- Chronic hepatitis B virus (HBV) infection affects numerous children worldwide.
- Antiviral therapies are crucial for managing pediatric chronic hepatitis B.
- Assessing the efficacy and tolerability of different interferon treatments is essential.
Purpose of the Study:
- To evaluate the antiviral efficacy of interferon gamma in children with chronic hepatitis B.
- To compare interferon gamma monotherapy and a combination therapy (interferon alfa followed by interferon gamma) against an untreated control group.
- To assess the tolerability of interferon gamma in this pediatric population.
Main Methods:
- A randomized controlled trial involving 35 children with chronic hepatitis B.
- Three treatment arms: untreated control, interferon gamma (1 MU/m2 thrice weekly for 24 weeks), and a combination of interferon alfa (5 MU/m2 thrice weekly for 12 weeks) followed by interferon gamma (1 MU/m2 thrice weekly).
- Hepatitis B virus DNA and hepatitis B e antigen levels were monitored at baseline, end of treatment (6 months), and follow-up (15 months).
Main Results:
- At 6 months, undetectable HBV DNA rates were 16.5% (control), 9% (interferon gamma), and 16.5% (combination).
- At 15 months, undetectable HBV DNA rates were 25% (control), 36% (interferon gamma), and 41.5% (combination).
- Hepatitis B e antigen loss was observed in 25% (control and combination) and 27% (interferon gamma) at 15 months. Interferon gamma was well-tolerated.
Conclusions:
- Interferon gamma demonstrates a modest antiviral effect in children with chronic hepatitis B, with no significant advantage over the control group in terms of hepatitis B e antigen loss.
- The combination therapy showed a trend towards higher undetectable HBV DNA rates at follow-up but did not significantly improve antigen loss.
- Interferon gamma is a safe and well-tolerated treatment option for pediatric chronic hepatitis B.
Abstract:
Thirty-five children with chronic hepatitis B were randomly assigned to three groups: group 1 (n = 12), untreated; group 2 (n = 11), treated with 1 million units of interferon gamma per square meter of body surface (MU/m2), three times a week for 24 weeks; and group 3 (n = 12), treated with interferon alfa at a dose of 5 MU/m2, three times a week for 12 weeks followed by 1 MU/m2 of interferon gamma with the same schedule. At the end of the treatment (6th month), hepatitis B virus DNA was negative in 16.5% of the control group, in 9% of the children treated with interferon gamma, and in 16.5% of those treated with interferons alfa and gamma. No child had lost the hepatitis B e antigen by this time. No basal differences in the serum hepatitis B virus DNA concentration among the groups were observed. At follow-up (15th month), viral genome was negative in 25% of the untreated children, in 36% of the group treated with interferon gamma, and in 41.5% of the children who had received interferons alfa and gamma. Hepatitis B e antigen was negative in 25% of the children who belonged to groups 1 and 3 and in 27% of the children treated with interferon gamma only. These data suggest that interferon gamma does not have a powerful antiviral effect on chronic hepatitis B in children. However, it is well tolerated.