Interferon-alpha treatment of children and young adults with chronic hepatitis delta virus (HDV) infection
Journal
Journal of the College of Physicians and Surgeons Pakistan
Journal Volume
21
Journal Issue
12
Pages
735-740
Date Issued
2011
Author(s)
Abstract
Objective: To determine the response of one-year interferon-alpha therapy in hepatitis delta virus (HDV) infection in children and young adults at a tertiary care hospital, Karachi, Pakistan. Study Design: An observational study. Place and Duration of Study: Sarwar Zuberi Liver Centre (SZLC), Medical Unit IV, Civil Hospital, Karachi / Dow University of Health Sciences (DUHS), from June 2009 to July 2010. Methodology: Paediatric patients (< 18 years age) and young adults (18-35 years) presenting were screened for hepatitis B virus (HBV) and HDV sero-markers. HDV anti-body positive by ELISA were further screened for hepatitis D ribonucleic acid (HDV-RNA) by real time PCR. HDV RNA PCR positive patients were treated with INF-α (children 6 MIU/m 2/day and adults 5 MIU/day) for a period of one year. Patients were assessed monthly. Haematological parameters and ALT were monitored during treatment. Clinical progress (side effects) and negative HDV RNA were used as response criteria. Results: Overall 49 patients were HDV RNA positive (children: n=15, mean age 15±2.92 years adults: n=34, mean age 27±4 years). Eighty percent were male. Treatment was given to 25 patients (children: n=11, adults: n=14). HBV genotype D was the predominant in all HDV RNA positive patients (73%). Eighty percent (20/25) were HDV-RNA negative after one year of treatment, and remaining patients are still under treatment. Side effects were tolerated well and children continued regular activity. Haematological parameters were unremarkable. Children maintained their pre-treatment centile for height and weight (growth parameters). ALT levels were significantly decreased post-treatment. Conclusion: Conventional INF-α was safe in children with HDV infection in terms of side effects and growth parameters. Eighty percent were HDV-RNA negative one year after treatment. Further follow-up 2 years post-treatment will give conclusive results.
Subjects
Children; HDV; Viral hepatitis; Young adults
SDGs
Other Subjects
alpha2a interferon; virus RNA; alpha interferon; antivirus agent; virus DNA; abdominal pain; adolescent; adult; alopecia; anorexia; anxiety disorder; article; child; clinical article; concentration loss; coughing; delta agent hepatitis; depression; diarrhea; drug eruption; drug fever; drug induced headache; drug response; drug tolerability; dry skin; dyspepsia; fatigue; female; genotype; human; immunotherapy; injection site inflammation; insomnia; irritability; malaise; male; mental instability; musculoskeletal pain; nausea; observational study; oral blister; outcome assessment; pruritus; school child; side effect; superinfection; vomiting; enzyme linked immunosorbent assay; genetics; Hepatitis D, Chronic; Hepatitis delta virus; isolation and purification; Pakistan; polymerase chain reaction; preschool child; treatment outcome; virology; young adult; Adolescent; Antiviral Agents; Child; Child, Preschool; DNA, Viral; Enzyme-Linked Immunosorbent Assay; Female; Hepatitis D, Chronic; Hepatitis Delta Virus; Humans; Interferon-alpha; Male; Pakistan; Polymerase Chain Reaction; Treatment Outcome; Young Adult
Type
journal article