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| |  DG DISPATCH - WCPGHN: Interferon Alpha Shows Long-Term Efficacy For Children With Chronic Hepatitis C By Maria Bishop Special to DG News
BOSTON, MA -- August 10, 2000 -- Interferon (IFN)-alpha demonstrated promising long-term efficacy results in the treatment of children infected with chronic hepatitis C virus (HCV), according to data from a study presented at the first World Congress of Pediatric Gastroenterology, Hepatology and Nutrition in Boston, MA. Since most children with chronic HCV infection are expected to later develop cirrhosis or hepatocellular carcinoma (HCC), Tomoo Fujisawa, MD, and colleagues felt that IFN therapy should be prescribed for all children with chronic HCV infection who are not expected to experience spontaneous remission. Their trial followed 68 children with chronic HCV infection for more than three years, explained Dr. Fujisawa, of the department of pediatrics at the National Defense Medical College, Tokorozawa, Japan. The study population was comprised of 37 children (27 male) who were positive for HCV RNA and who had had abnormal alanine aminotransferase (ALT) levels for more than six months. The treatment group received natural IFN-alpha at a dosage of 0.1 MIU/kg (maximum 6.0 MIU) daily for the first two weeks and then three times per week for an additional 22 weeks. The total dose was 8.0 MIU/kg. In this trial, a complete response was considered HCV RNA negativity and an ALT level less than 30 IU/l. A complete response at the end of treatment was obtained in 33 of the 37 treated children (89 percent). This response was sustained by 17 children (46 percent) three years after treatment. The efficacy of IFN depends on high baseline ALT values (greater than 80 IU/l), a low serum titre of HCV RNA (less than 1 Meq/ml), an HCV genotype other than 1b, and having no underlying malignant disease. The sustained response rates in this trial were 75 percent, 62 percent, 75 percent and 67 percent, respectively. IFN was well tolerated by this study population, and the researchers suggested that any child with chronic HCV infection who is likely to respond to IFN should be offered the therapy. Approximately 50 percent of infected children, however, may not achieve a sustained response. Further trials of combination therapies with drugs such as ribavirin are necessary to establish the standard treatment for children with chronic HCV infection, the researchers said. In this trial, the route of infection in 33 of the 37 treatment-group children (95 percent) was blood transfusion. Twenty of the children were malignant-disease survivors. Related Link: interferon.
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