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| |  DG DISPATCH - WCPGHN: High-Dose Interferon Alpha Effective And Tolerable For Chronic Hepatitis B In Children By Maria Bishop Special to DG News
BOSTON, MA -- August 10, 2000 -- High-dose interferon (IFN)-alpha was shown to be effective and well tolerated in children infected with chronic hepatitis B, according to data presented at the first World Congress of Pediatric Gastroenterology, Hepatology and Nutrition in Boston, MA. IFN-alpha2b therapy has proven useful in treating chronic hepatitis-B virus (HBV) infection in children. Since the response rate in clinical trials has always been higher in the high-dose interferon groups, researchers from the Marmara University Faculty of Medicine and the Social Security Okmeydani Hospital in Istanbul, Turkey, decided to test the tolerability of higher doses in children. This trial, led by Deniz Ertem, MD, pediatric gastroenterologist at Marmara University, comprised 41 children (28 boys) with biopsy-proven chronic HBV infection. Patients received IFN-alpha subcutaneously three times a week for six months. The treatment regimen was completed in 36 children, while a second liver biopsy was carried out in 26 of these children at 12 months post-treatment. Results showed that 33.3 percent of the children had a persistent loss of HBV DNA at 12 months post-treatment, while 47.2 percent had lost hepatitis B e antigen (HbeAg) and 19.4 percent had developed anti-hepatitis B s (AntiHBs) antibody with a loss of hepatitis B s antigen (HbsAg). A statistically significant improvement in liver histology was obtained in the 12 children with HBV DNA clearance. Histological improvement was most strikingly seen in the regression of portal inflammation and lobular necrosis. Serum alanine aminotransferase (ALT) levels became normal in all HbeAg seroconverted patients, and, in this population, there was a statistically significant difference in ALT levels before and one year after completion. Dr. Ertem noted that "no significant side effects were observed to cause a patient to withdraw from this treatment". The findings, he added, suggest that the high-dose interferon treatment was well tolerated in this study population. Importantly, high-dose interferon resulted in a high rate of HBV clearance and AntiHBs antibody development in a group of children with chronic HBV infection. Approximately 5 percent to 10 percent of those people infected with HBV will become carriers. An estimated 5 percent to 10 percent of those infected each year will also progress to chronic liver disease, cirrhosis and possibly liver cancer. Related Link: interferon.
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