Response
to Pegylated Interferon in Adolescents with Chronic Hepatitis B By
Liz Highleyman In
a study presented at the Digestive Disease Week (DDW) 2008
conference last week in San Diego, investigators assessed virological response
after 4, 24 and 48 weeks of treatment with pegylated
interferon in children with chronic hepatitis
B. Thirteen
adolescents aged 11-17 years (9 male, 4 female) were treated with 100 mcg/m2/week
pegylated interferon alfa-2a (Pegasys);
total doses ranged from 135-180 mcg/week. Five patients were hepatitis B "e"
antigen (HBeAg) positive and 8 were HBeAg negative. Four had previously been treated
with conventional interferon. At baseline, none had liver disease greater than
grade 2/stage 2. Serum
HBV DNA was measured at baseline and after 4 weeks and 24 weeks of treatment.
ALT levels, blood cell levels, and adverse events were also monitored. Results
•
After
4 weeks on treatment, the median HBV DNA level had decreased from 7.8 x 103 IU/mL
at baseline to 1.43 x 102 IU/mL (P < 0.01).
•
Rapid
virological response (RVR), or undetectable HBV DNA at 4 weeks, was observed in
6 patients.
•
RVR
was associated with lower pretreatment ALT levels (<25 IU) and lower pretreatment
viral load (HBV DNA < 750 IU/mL).
•
All
patients with RVR were HBeAg negative prior to treatment.
•
After
24 and 48 weeks of treatment, 7 patients - including all the adolescents with
RVR - still had undetectable HBV DNA.
•
In
2 of the 6 subjects with RVR, hepatitis B surface antigen (HBsAg) loss was observed
at the end of treatment.
•
Leukocyte
(white blood cell) counts decreased significantly in most children during the
first 4 weeks of treatment.
•
Leukopenia
(white blood cell deficiency) was reported in 7 patients, while 3 developed thrombocytopenia
(low platelet count).
•
4
patients discontinued treatment before 48 weeks.
•
No
adverse events were observed following dose modification.
Conclusion "These
observations suggest that [pegylated
interferon alfa-2a] is a good therapeutic option for children with chronic
hepatitis B and, in particular, those with HBeAg negative chronic hepatitis B,"
the researchers concluded. They
added that, "Low pretreatment viral load and rapid viral response seem to
be predictive factors of efficient therapy."
5/23/08
Reference
M
Pawlowska and W Halota. Virological response during treatment of chronic hepatitis
B with pegylated interferon alfa-2a in children. Digestive Disease Week (DDW)
2008. San Diego, CA. May 17-22, 2008. Abstract M1922.
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