Background and Objective: The course of chronic hepatitis C in children is often mild or asymptomatic, but may lead to liver cirrhosis and neoplasm. The aim of our study was retrospective evaluation of treatment efficacy using pegylated interferon (IFN)-α2b with ribavirin in children and adolescents with chronic hepatitis C, both treatment naïve and re-treated.
Methods: The study comprised 79 patients with chronic hepatitis C ages 8 to 18 years (43 patients re-treated; 54 infected with genotype 1 hepatitis C virus and 25 with genotype 4), treated with pegylated IFN-α2b (1.5 μg · kg−1 · week−1) plus ribavirin (15 mg · kg−1 · day−1) for 48 weeks. The primary endpoint was sustained virologic response (SVR).
Results: Early viral response (EVR) was observed in 43.1% and end-of-treatment response in 47.9% of patients. In 44.3% of patients, SVR was achieved, which was maintained for at least the next 6 months. Patients not treated before significantly more frequently attained EVR, end-of-treatment response, and SVR (64%, 65.6%, and 63.9%, respectively) as compared with re-treated patients (30%, 33.3%, and 27.9%, respectively). Among 28 patients who attained EVR, 23 achieved SVR. In 2 patients, despite lack of EVR, SVR was observed. There were numerous adverse effects. They were not so severe as to discontinue therapy.
Conclusions: Combined therapy with pegylated IFN-α2b and ribavirin in patients with chronic hepatitis C, infected with hepatitis C virus genotypes 1 and 4, was more effective in treatment-naïve patients (63.9%) as compared with re-therapy cases (27.9%). SVR was maintained for at least the next 6 months in all of the patients. The applied treatment has limited efficacy and evokes numerous adverse effects; thus, search for new methods of treatment is mandatory.
*3rd Department of Paediatrics, Polish Mother's Memorial Hospital, Research Institute, Lodz
†Department of Infectious Diseases and Hepatology, Collegium Medicum, Mikołaj Kopernik University, Bydgoszcz, Poland.
Address correspondence and reprint requests to Teresa Wozniakowska-Gesicka, MD, 3rd Department of Paediatrics, Polish Mother's Memorial Hospital, Research Institute, Str. Rzgowska 281/289, 93-338 Lodz, Poland (e-mail: firstname.lastname@example.org).
Received 2 August, 2013
Accepted 2 August, 2013
The authors report no conflicts of interest.