[Preliminary results of interferon alpha-2a and lamivudine combination therapy regimen in children with chronic hepatitis B].

The combination therapy regimen of interferon (IFN)-alpha and lamivudine (LAM), a nucleoside analogue, is lately in use in chronic hepatitis B (CHB) infections. The aim of this study was the evaluation of the efficacy of IFN-alpha 2a and LAM combination therapy in children with CHB infection. Twenty-seven cases (mean age 10.4 +/- 3.7 years, 20 males) who were followed up between 2002 and 2005 in Pediatric Gastroenterology Department, were included in the study. IFN-alpha 2a (5 MU/m2 SC, three times a week for 6 months) and LAM (4 mg/kg/d PO, maximum 100 mg/d for one year) were given simultaneously. LAM medication was extended to two years in non-responders. Alanine aminotransferase (ALT) levels, hepatitis markers and HBV-DNA were monitored once in three months. "Partial" response was defined as normal levels of ALT and negative HBV-DNA, and "complete" response was defined as seroconversion of HBeAg/anti-HBe. The cases whose HBV-DNA not getting negative and whose ALT levels did not decrease to the normal values were defined as "non-responders". In our study, one case (4.3%) was found non-respondant, "partial" response was seen in 13 (56.5%) cases, whereas "complete" response was seen in 9 cases (39.1%) out of 23 cases who have got the medications as long as a year. There was no significant difference between the response to the therapy regimen and the age, sex, ALT levels, hepatic activity indices (HAI) and HBV-DNA levels (p>0.05). As a result, IFN-alpha 2a and LAM combination therapy regimen is an effective alternative therapy in childhood, and the efficacy of the therapy was not influenced by age, sex, initial ALT levels, HBV-DNA and HAI in our study group.

[1]  H. Demir,et al.  Lamivudine and High-dose Interferon-α Combination Therapy for Naive Children With Chronic Hepatitis B Infection , 2005, Journal of clinical gastroenterology.

[2]  S. Aydoğdu,et al.  Comparison of antiviral effect of lamivudine with interferon-alpha2a versus -alpha2b in children with chronic hepatitis B infection. , 2004, Antiviral therapy.

[3]  S. Hadziyannis,et al.  Current management of chronic hepatitis B , 2004, Alimentary pharmacology & therapeutics.

[4]  H. Lee,et al.  Combination of alpha-interferon with lamivudine reduces viral breakthrough during long-term therapy. , 2004, Journal of gastroenterology and hepatology.

[5]  Man-Fung Yuen,et al.  Viral hepatitis B , 2003, The Lancet.

[6]  R. Shamir,et al.  Lamivudine treatment for chronic hepatitis B infection in children unresponsive to interferon , 2003, The Pediatric infectious disease journal.

[7]  B. Dikici,et al.  Combination therapy for children with chronic hepatitis B virus infection , 2002, Journal of gastroenterology and hepatology.

[8]  B. Dikici,et al.  Comparison of treatments of chronic hepatitis B in children with lamivudine and α‐interferon combination and α‐interferon alone , 2002, Pediatrics international : official journal of the Japan Pediatric Society.

[9]  N. Leung Treatment of chronic hepatitis B: Case selection and duration of therapy , 2002, Journal of gastroenterology and hepatology.

[10]  G. Barbarini,et al.  Long-term efficacy of interferon alpha-2b and lamivudine in combination compared to lamivudine monotherapy in patients with chronic hepatitis B. An Italian multicenter, randomized trial. , 2001, Journal of hepatology.

[11]  D. Pillay,et al.  Additive antiviral effects of lamivudine and alpha-interferon in chronic hepatitis B infection. , 2000, Antiviral therapy.

[12]  K. Simon,et al.  HBV-DNA level in blood serum as a predictor of good response to therapy with interferon-alpha-2b of patients with chronic hepatitis B. , 2000, Medical science monitor : international medical journal of experimental and clinical research.

[13]  A. Dhillon,et al.  Lamivudine and alpha interferon combination treatment of patients with chronic hepatitis B infection: a randomised trial , 2000, Gut.

[14]  R. Schinazi,et al.  Enhanced Antiviral Benefit of Combination Therapy with Lamivudine and Alpha Interferon against WHV Replication in Chronic Carrier Woodchucks , 1999, Antiviral therapy.

[15]  H. Ozen,et al.  Comparison of standard and high dosage recombinant interferon alpha 2b for treatment of children with chronic hepatitis B infection. , 2000, The Pediatric infectious disease journal.

[16]  W. Hop,et al.  Interferon alfa for chronic hepatitis B infection: Increased efficacy of prolonged treatment , 1999, Hepatology.