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Peginterferon Therapy in Children With Chronic Hepatitis C: A Nationwide, Multicenter Study in Japan, 2004-2013
Mitsuyoshi Suzuki1, Hitoshi Tajiri, Yasuhito Tanaka
1*Department of Pediatrics, Juntendo University Graduate School of Medicine, Tokyo, Japan†Department of Pediatrics, Osaka General Medical Center, Osaka, Japan‡Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan§Department of Pediatrics, Osaka University, Graduate School of Medicine, Osaka, Japan||Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Tottori, Japan¶Department of Microbiology/Immunology, State University of New York, Buffalo, NY.
Insights
Pegylated interferon-based therapies demonstrated effectiveness and safety in treating chronic hepatitis C in Japanese children and adolescents. The IL28B genotype aided in predicting treatment outcomes for pegylated interferon/ribavirin combination therapy.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Virology
Background:
- Chronic hepatitis C virus (HCV) infection affects children and adolescents globally.
- Treatment strategies for pediatric HCV have evolved, necessitating reviews of past therapeutic approaches.
- Understanding treatment efficacy and safety in pediatric populations is crucial for clinical management.
Purpose of the Study:
- To review the medical treatment of Japanese children and adolescents diagnosed with chronic hepatitis C over a 10-year period.
- To evaluate the efficacy and safety of pegylated interferon (PEG-IFN) monotherapy and PEG-IFN/ribavirin (RBV) combination therapy in pediatric patients.
- To investigate the role of IL28B genotype polymorphism in predicting treatment response.
Main Methods:
- A nationwide, multicenter study involving pediatric patients (<18 years) treated between 2004 and 2013.
- Analysis of treatment outcomes (sustained virological response - SVR) for PEG-IFN monotherapy versus PEG-IFN/RBV combination therapy.
- IL28B genotype polymorphism (rs8099917) analysis in patients with HCV genotype-1 infection.
Main Results:
- Sustained virological response (SVR) rates varied by HCV genotype and treatment regimen.
- For genotype-1, SVR rates were 100% (PEG-IFN monotherapy) and 72% (PEG-IFN/RBV).
- For genotype-2, SVR rates were 75% (PEG-IFN monotherapy) and 100% (PEG-IFN/RBV).
- The IL28B major allele group showed a significantly higher SVR rate (P=0.021) with PEG-IFN/RBV combination therapy in genotype-1 patients.
- Adverse event frequencies were comparable between treatment groups.
Conclusions:
- Both PEG-IFN monotherapy and PEG-IFN/RBV combination therapy showed encouraging efficacy and reasonable safety in Japanese pediatric patients with chronic hepatitis C.
- The IL28B genotype is a valuable predictor of treatment response to PEG-IFN/RBV combination therapy in this cohort.
- These findings support the use of interferon-based treatments and genetic markers in managing pediatric chronic hepatitis C.
Objectives:
The aim of the present study was to review the medical treatment of Japanese children and adolescents with chronic hepatitis C in the past 10 years.
Methods:
This nationwide, multicenter study evaluated patients who were younger than 18 years of age when diagnosed with chronic hepatitis C virus (HCV) infection and were treated with pegylated interferon (PEG-IFN) monotherapy or PEG-IFN/ribavirin (RBV) combination therapy between 2004 and 2013. The subjects' median age was 10 (3-18) years, with a male to female ratio of 52:50 and a genotype-1 to genotype-2 ratio of 45:57. Among the 102 patients, 18 received PEG-IFN monotherapy and 84 received PEG-IFN/RBV combination therapy. The IL28B genotype polymorphism was analyzed in patients infected with genotype-1.
Results:
In patients with HCV genotype-1 infections, sustained virological response (SVR) rates obtained by PEG-IFN monotherapy and by PEG-IFN/RBV combination therapy were 100% (2/2) and 72% (31/43), respectively. In patients with HCV genotype-2 infections, SVRs were 75% (12/16) and 100% (41/41), respectively. In 32 genotype-1 patients available for the IL28B genotype (rs8099917), SVR was achieved in more patients in the IL28B major allele group than in the minor allele group (15/17 vs 7/15, P = 0.021) after PEG-IFN/RBV combination therapy. The frequencies of adverse events were similar between the treatment regimens.
Conclusions:
Overall, both therapies showed encouraging results, and were reasonably safe in children and adolescents with chronic hepatitis C. The IL28B genotype was useful for predicting the treatment response to PEG-IFN/RBV combination therapy in this cohort.
