The Effect of Early Treatment in Children with Chronic Hepatitis
作者:
Corina Hartman,
Drora Berkowitz,
Nurit Rimon,
Raanan Shamir,
期刊:
Journal of Pediatric Gastroenterology and Nutrition
(OVID Available online 2003)
卷期:
Volume 37,
issue 3
页码: 252-257
ISSN:0277-2116
年代: 2003
出版商: OVID
关键词: Children;Chronic hepatitis C;Interferon;Ribavirin
数据来源: OVID
摘要:
BackgroundThe aim of this study was to compare the efficacy of interferon alpha (IFN) or IFN and ribavirin (IFN+RIB) combination therapy in children with chronic hepatitis C (CHC). Most children were infected during treatment for pediatric malignancies.Patients and MethodsWe reviewed the charts of 20 patients (11 boys and 9 girls) aged 10.6 ± 3.7 years with CHC who were treated between 1995 and 2001. Seven patients diagnosed with CHC before 1998 were treated with 3 million units of IFN three times weekly for 6 to 12 months. Thirteen children diagnosed after 1998 were treated with 3 million units of IFN three times weekly plus 15 mg/kg of ribavirin daily for 6 months (IFN+RIB).ResultsDemographic and clinical characteristics were not different between the two treatment groups. A sustained complete response defined as serum alanine aminotransferase normalization and hepatitis C virus RNA clearance at 6 and 12 months after termination of treatment occurred in three of seven children (43%) treated with IFN monotherapy compared with 7 of 12 children (54%) in the group treated with IFN+RIB combination therapy (not significant). The only difference between responders and nonresponders was the duration of infection before the initiation of therapy, which was significantly shorter in responders (1 ± 0.3 vs. 5.6 ± 2.2;P= 0.001).ConclusionsIn this small cohort of children with CHC, early initiation of antiviral treatment was associated with a sustained response rate independent of treatment type. Regular follow-up of children at risk of acquiring hepatitis C virus infection should assist in the early diagnosis. Early initiation of antiviral treatment may improve the rate of sustained response.
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