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Predictive factors and virological response to interferon treatment in children with chronic hepatitis B.

Journal article
Authors Ann Söderström
Magnus Lindh
Kajsa Ekholm
Nils Conradi
Peter Horal
Marie Krantz
Catharina Hultgren
Gunnar Norkrans
Published in Scandinavian journal of infectious diseases
Volume 37
Issue 1
Pages 40-7
ISSN 0036-5548
Publication year 2005
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Laboratory Medicine, Dept of Pathology
Institute for the Health of Women and Children, Dept of Paediatrics
Institute of Laboratory Medicine, Dept of Clinical Virology
Pages 40-7
Language en
Links dx.doi.org/10.1080/0036554041002603...
Keywords Adolescent, Antiviral Agents, adverse effects, therapeutic use, Child, Child, Preschool, DNA, Viral, blood, drug effects, Female, Hepatitis B virus, drug effects, Hepatitis B, Chronic, drug therapy, enzymology, pathology, Humans, Interferon-alpha, adverse effects, therapeutic use, Male, Neutropenia, chemically induced, Predictive Value of Tests
Subject categories Medical and Health Sciences

Abstract

Further knowledge about factors predicting response to interferon treatment for chronic hepatitis B in children is required, in particular as the benefits of therapy are uncertain. In the present study, baseline characteristics were related to virological and histological responses in 27 children given interferon-alpha for 24 weeks after steroid priming. HBe seroconversion was seen in 8 of 27 HBeAg positive patients and was accompanied by a sustained virological response (SR), with a median 4.1 log HBV DNA reduction. Pretreatment viraemia level was the only baseline parameter associated with SR. After 12 weeks of IFN (mid-treatment), viraemia was significantly reduced in all patients, with a median of 3.0 (range 0.6-5.2) log decline in SR compared with 0.6 (range -0.5-3.6) log decline in non-sustained responders (NSR). HBV DNA levels below 1 million copies/ml at week 12 predicted sustained response with a positive predictive value of 75% and a negative predictive value of 89%. During the latter half of the IFN treatment HBV DNA tended to increase by a mean of 0.4-0.5 log for all patient groups. Flares during IFN treatment were rare or mild as measured by ALT. Pretreatment anti-HBc IgM was associated with liver damage but not with response. Histological inflammation scores were improved in SR. Thus, pretreatment HBV DNA levels were associated with IFN response, and the virological response at week 12 predicts SR and may be useful in the decision to continue or modify therapy.

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