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Factors predictive of response to interferon therapy in children with chronic hepatitis B
M Ruiz-Moreno1, T Camps, J Jimenez
1Department of Pediatrics, Fundación Jiménez Diaz, Madrid, Spain.
Insights
Predicting interferon therapy response in children with chronic hepatitis B is possible. Key factors include histological activity and viral markers, similar to adults, aiding treatment selection.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Virology
Background:
- Interferon therapy efficacy in Caucasian children with chronic hepatitis B is comparable to adults.
- Limited data exists on predictors of treatment response specifically in pediatric populations.
- This study aimed to identify factors influencing interferon response in children with chronic hepatitis B.
Purpose of the Study:
- To perform univariate and multivariate analyses to identify basal variables predicting interferon therapy response in children.
- To determine the optimal combination of variables for predicting response with high sensitivity and specificity.
Main Methods:
- Analysis of basal parameters in 50 children undergoing interferon alpha therapy across three trials.
- Therapy involved doses of 360-700 MU/m²/week, administered 2-3 times weekly for 12-24 weeks.
Main Results:
- 18 out of 50 children (36%) were responders.
- Univariate analysis showed higher histological activity, lower HBcAg-stained hepatocytes, elevated AST/ALT levels, and a higher ALT peak before HBV-DNA clearance predicted response.
- Multivariate analysis identified combinations of HBcAg-stained cells with ALT levels or histological activity as best predictors (sensitivity: 100%, specificity: 89-86%).
Conclusions:
- Predictive factors for interferon response in children with chronic hepatitis B mirror those observed in adults.
- These findings can assist in identifying pediatric patients likely to benefit from interferon therapy.
Background/Aims:
The efficacy of interferon therapy in Caucasian children with chronic hepatitis B is similar to that in adults. However, little information is available about factors predicting response to this therapy in children. We have performed a univariate analysis to assess the strength of association between basal variables and response, and a multivariate analysis to determine the combination of basal variables which give the best prediction of response in terms of sensitivity and specificity.
Methods:
The basal parameters were studied in 50 children included in three different trials of interferon alpha therapy (360-700 MU/square meter of body surface, 2 or 3 times weekly for 12 to 24 weeks).
Results:
Of these, 18 (36%) were responders. In the univariate analysis, a higher histological activity (p < 0.05), a lower percentage of HBcAg-stained hepatocytes (p < 0.001), aspartate amino transferase and alanine aminotransferase levels (p < 0.05) and alanine aminotransferase peak prior to serum HBV-DNA clearance (p < 0.05), were associated to the response. In the multivariate analysis, the combinations of the percentage of HBcAg stained cells with alanine aminotransferase levels and with the histological activity index were the best variables for predicting response (sensitivity: 100% and specificity: 89% and 86%, respectively).
Conclusions:
Factors predictive of response in children with chronic hepatitis B are similar to those found in adults, and may help in identifying those children with a better chance of responding.