Virologic response to treatment with Pegylated Interferon alfa-2b and Ribavirin for chronic hepatitis C in children
Malgorzata Pawlowska, Malgorzata Pilarczyk, Waldemar Halota
Med Sci Monit 2010; 16(12): CR616-621
Background: This study assessed the efficacy and safety of treatment of chronic hepatitis C in children with pegylated interferon alpha and ribavirin.
Material/Methods: Investigations were performed on 53 children with chronic hepatitis C, aged 8–17 years. Children were divided into 2 groups: naïve (n=29) and retreated (n=24). All children were administered a combined therapy with pegylated interferon (IFN) alpha-2b 1.5 mcg/kg/wk and ribavirin 15 mg/kg/d for 48 weeks.
Mean baseline viral load was 0.456×106 IU/mL, mean alanine aminotransferase (ALT) activity was 45.8±24.3 IU/mL. No child had liver disease assessed greater than grade 2, stage 2 according to modified Scheuer scale. Serum hepatitis C virus (HCV) RNA in TW 12-EVR, TW 48-ETR, and W 72-sustained virologic response (SVR) with the polymerase chain reaction (PCR) method (Roche TaqMan) were evaluated.
Results: Sustained virologic response was achieved in 47% of children. The prevalence of relapses was 7.5%. The most important predictor of SVR in both groups was undetectable HCV RNA at TW 12. All retreated children who achieved partial EVR – (the HCV RNA level decreased more than 2 logs relative to baseline) were relapsers. In responders from both groups, baseline ALT activity was higher and baseline viral load was lower. In all children who achieved SVR, HCV RNA was undetectable 12 months later.
Conclusions: Pegylated IFN and ribavirin are effective in treating chronic hepatitis C in children. Complete EVR is predictive of a sustained viral response. And high rate of relapses in retreated patients may suggest a longer duration of retherapy.
Keywords: Polymerase Chain Reaction, Recombinant Proteins, Polyethylene Glycols - therapeutic use, Interferon-alpha - therapeutic use, Humans, Hepatitis C, Chronic - drug therapy, Hepacivirus - genetics, Child, Alanine Transaminase - blood, Ribavirin - therapeutic use, Treatment Outcome