Related Experiment Videos
Effect of recombinant alpha 2 interferon with or without prednisone in Chinese HBsAg carrier children
Insights
This study investigated the efficacy of recombinant alpha 2b-interferon with or without prednisone in Chinese children with chronic Hepatitis B virus (HBV) infection. Prednisone priming followed by interferon showed promise in achieving HBV DNA loss and e-seroconversion.
Area of Science:
- Hepatology
- Virology
- Pediatric Infectious Diseases
Background:
- Chronic Hepatitis B virus (HBV) infection remains a significant global health concern, particularly in Asia.
- Hepatitis B e antigen (HBeAg) positivity in children indicates active viral replication and infectivity.
- Identifying effective treatment strategies for pediatric HBV carriers is crucial for long-term outcomes.
Purpose of the Study:
- To evaluate the efficacy of recombinant alpha 2b-interferon (rIFN2b) in treating HBeAg-positive Chinese children with chronic HBV.
- To assess the potential synergistic effect of short-term prednisone priming on rIFN2b treatment outcomes.
- To determine the rates of HBV DNA loss and seroconversion to anti-HBe and anti-HBs.
Main Methods:
- A randomized controlled trial involving 90 HBsAg carrier children aged 2-17 years.
- Three treatment arms: control (vitamin B complex), rIFN2b alone, and prednisone followed by rIFN2b.
- Treatment duration involved 6 weeks of prednisone/placebo followed by 16 weeks of rIFN2b, with a 24-month follow-up.
Main Results:
- Persistent HBV DNA loss occurred in 16.1% of children receiving prednisone plus rIFN2b, compared to none in the control group (p=0.0571).
- E-seroconversion (anti-HBe) was observed in 12.9% of the prednisone + rIFN2b group.
- Increased transaminase levels were more frequent in the prednisone + rIFN2b group (p=0.0144), but side effects were transient and acceptable.
Conclusions:
- Short-term prednisone priming followed by recombinant alpha 2b-interferon can induce persistent HBV DNA loss and e-seroconversion in a proportion of Chinese children with chronic HBV.
- Prednisone may enhance the immunomodulatory effects of rIFN2b, suggesting a potential role in combination therapy.
- This regimen offers a viable option for managing pediatric HBV carriers, warranting further investigation.
Abstract:
Ninety Chinese hepatitis B surface antigen (HBsAg) carrier children, aged 2-17 years, positive for hepatitis B e antigen (HBeAg) and hepatitis B virus DNA on at least three occasions in 6 months, were randomized into 3 groups. Thirty children received syrup vitamin B complex as control, 29 received 6 weeks of placebo syrup followed by 16 weeks of recombinant alpha 2b-interferon [intron A (rIFN2b)], 5 x 10(6) u/m2 subcutaneously thrice weekly; and 31 received 6 weeks of syrup prednisone (0.6 mg/kg tailed to 0.2 mg/kg) followed by 16 weeks of recombinant alpha 2b-interferon as above. The placebo/prednisone syrup was given on a double-blind basis. At 24 months of follow-up, persistent loss of hepatitis B virus DNA occurred in none of the children in the control group, in one child receiving recombinant alpha 2b-interferon alone, who also seroconverted to anti-HBe and anti-HBs and in five children receiving interferon with steroid priming (p = 0.0571 compared with controls), with four seroconverting to anti-HBe and one also seroconverting to anti-HBs. A rise of transaminases to above twice the upper limit of normal levels during the first 7 months of follow-up occurred in one subject in the control group, four in the group receiving alpha 2b-interferon alone and nine in the group receiving recombinant alpha 2b-interferon with steroid priming (p = 0.0144 compared with controls). Side effects of the steroid were negligible; those of recombinant alpha 2b-interferon were transient and acceptable. We conclude that 6 weeks of prednisone followed by 16 weeks of recombinant alpha 2b-interferon is of use in inducing persistent loss of hepatitis B virus DNA (16.1 per cent) and e-seroconversion (12.9 per cent) in a proportion of Chinese HBsAg carrier children: the prednisone probably enhances the immunomodulatory effect of recombinant alpha 2b-interferon.