|Title:||Interferon-Alpha Treatment in Children and Young Adults with Chronic Hepatitis B: A Long-Term Follow-up Study in Taiwan||Authors:||HSU, HONG-YUAN
WU, TZEE -CHUNG
|Keywords:||children;chronic hepatitis B;interferon-alpha therapy;young adults||Issue Date:||2008||Journal Volume:||v.28||Journal Issue:||n.9||Start page/Pages:||1288-1297||Source:||LIVER INTERNATIONAL||Abstract:||
Background/Aims: The short- and long-term benefits of interferon (IFN)- alpha therapy in young patients with chronic hepatitis B (CHB) acquiring infection perinatally or during early childhood have been questioned. Methods: Twenty-one Taiwanese hepatitis B envelope antigen (HBeAg)- positive CHB patients aged 1.8-21.8 years (median 14.0 years ) with alanine aminotransferase (ALT)> 80 IU/L at entry were enrolled for IFN- alpha therapy. They received IFN-alpha therapy with a dose of 3 MU/m(2)/ day three times a week for 24 weeks. A control group included untreated 21 CHB patients closely matched for gender, age, duration of ALT > 80 IU/L and HBeAg status. All 42 patients were prospectively followed for 6.5-12.5 years after the end of therapy. Results: The cumulative rate of virological response [anti- HBe seroconversion and serum hepatitis B virus (HBV)-DNA < 10(5) copies/ml] was not different between the IFN-treated patients and control patients at 1 year (41 vs 44%) and at 6 years (88 vs 89%) after stopping treatment. Serum hepatitis B surface antigen loss occurred in two (9.5%) treated patients and in one (4.8%) control patient. Patients with a successful treatment response (anti-HBe seroconversion, HBV- DNA < 10(2) copies/ml and ALT normalization at 1 year after stopping treatment) were younger than those without a successful response (P=0.03). A lower pretreatment serum HBV -DNA level (< 2 x 10(8) copies/ml) is not only a significant factor to predict successful treatment response (P=0. 008) but also has a beneficial effect on the long-term cumulative rate of virological response in IFN-treated patients (P=0. 021), but not in control patients. Genotype difference or emergence of a precore stop codon mutant before treatment was not predictive for HBeAg clearance. Conclusions: For young CHB patients in Taiwan with infection occurring perinatally or in early childhood, the real advantage of IFN -alpha therapy was not observed. IFN-alpha therapy showed a beneficial effect on short- and long-term virological outcomes only in those with a lower pretreatment serum HBV- DNA level.
|Appears in Collections:||醫學系|
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