Factors Predictive of Response to Interferon-alpha Therapy in Children with Chronic Hepatitis B

ABSTRACT

PURPOSE: The efficacy and safety of interferon-alpha (IFN-alpha) therapy in children with chronic hepatitis B (CHB) is similar to that of adults. However, little information is available about the predictive factors of response to this therapy in children. The aim of this study was to determine the predictive factors for responsiveness to IFN-alpha therapy in children with CHB. METHODS: The basal parameters were studied in 35 children with CHB treated with IFN-alpha (300MU/m2 of body surface area subcutaneously, 3 times weekly for 6 months). HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA and aminotransferase levels were assessed serially. Pretreatment liver biopsies were performed in 16 patients and modified histologic activity index(HAI) was determined respectively. Responder was defined as disappearance of HBeAg and HBV-DNA after cessation of therapy. We analyzed the predictive factors of response to IFN-alpha therapy. RESULTS: Serum HBeAg and HBV DNA became negative in 16 children (46%) among 35 treated children at the time of cessation of therapy. In the univariate analysis, HAI, ALT level and maternal HBsAg were associated with the response. In multivariate analysis, HAI was the best factor for predicting response (sensitivity 80% and specificity 100%). CONCLUSION: Factors predictive of response in children with CHB are similar to those reported in adult, and may help identify those children with a better chance of responding.