The Effect of Early Treatment in Children with Chronic Hepatitis

Author:

Hartman Corina1,Berkowitz Drora1,Rimon Nurit2,Shamir Raanan1

Affiliation:

1. Division of Pediatric Gastroenterology and Nutrition Meyer Children's Hospital of Haifa Haifa Israel

2. Laboratory of Virology Rambam Medical Center Bruce Rappaport School of Medicine Technion‐Israel Institute of Technology Haifa Israel

Abstract

ABSTRACTBackgroundThe 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.

Publisher

Wiley

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