HBV DNA suppression during entecavir treatment in previously treated children with chronic hepatitis B.

The aim of this study was to assess HBV DNA suppression after 24 weeks of treatment with entecavir in previously treated children with CHB. Thirty children aged 5-17 years (25 males and 5 females) with CHB were treated with entecavir 0.5 or 1 mg daily. Twenty-two children were HBeAg-positive, eight were HBeAg-negative, and in eight HBV polymerase mutations were detected. After 24 weeks of treatment, mean and median HBV DNA levels and ALT activity were lower versus baseline, overall and in both subgroups. The overall median HBV DNA level decreased from 1.2 x 10(7) IU/mL to 3.3 x 10(2) IU/mL (p < 0.000004), in HBeAg-positive from 7.8x10(7) IU/mL to 6.3x10(3) IU/mL (p < 0.00004), and in HBeAg-negative from 2.5x10(4) IU/mL to 5.01x10(1) IU/mL (p < 0.03). The serum HBV DNA disappearance was observed in 7/8 (88%) HBeAg-negative and in 5/22 (23%) HBeAg-positive patients. The overall mean ALT activity decreased from 164+ 290 U/L to 34.1+ 18.9 U/L (p < 0.000007), in HBeAg-positive from 214+326 U/L to 38.59+19.2 U/L (p < 0.000074), and in HBeAg-negative from 27+14 U/L to 20+8 U/L (p < 0.03). Twenty-four weeks of treatment with entecavir results in suppression of HBV DNA in a substantial proportion of children previously treated ineffectively with CHB.

Effect of IFN-alpha on total haemolytic activity of CH50 complement system and C3, C4 levels in children with chronic hepatitis C.

BACKGROUND: The pathogenesis of chronic hepatitis induced by virus C as well as the mechanisms responsible for the elimination of this infection are still not fully understood. The course of HCV infection depends on the extent to which both specific and non-specific response is induced. One of the treatment methods applied in HCV is the use of IFN-alpha which has both antiviral and immunomodulatory activity. The knowledge of IFN-alpha effect on non-specific humoral response may be helpful in the choice of optimal strategy for HCV prevention and treatment. The purpose of the study was the assessment of total haemolytic activity of CH50 complements as well as C3 and C4 levels in children with chronic hepatitis C treated with IFN-alpha. MATERIAL AND METHODS: Sixty children aged 3-15 years with chronic hepatitis C were included in the study. The diagnosis was based on biochemical examinations, the presence of HCV RNA and histological investigations of the liver. The study group was divided into two subgroups of 30 children each. One subgroup was treated with subcutaneous recombined IFN-alpha (Intron A Schering Plough) at the dose of 3 MU 3 times a week for 6 months, while the other subgroup was a control. All the children underwent the assessment of total haemolytic activity of CH50 complement according to modified Mayer's technique as well as the concentration of its components C3 and C4 with turbidimetric method with the use of Behring reagents and Turbi Time system. The assessments were performed at the beginning of the study and 6 months later. RESULTS: Total haemolytic activity of CH50 complement and C3, C4 levels after 6 months of IFN-alpha therapy were significantly higher in children on IFN-alpha when compared to control group. Among children treated with IFN-alpha, 9 managed to eliminate HCV genetic material from blood serum. Mean values of analysed parameters did not differ at both stages of the study in the IFN-alpha group between the children with and without HCV RNA elimination. CONCLUSIONS: Higher total haemolytic activity of CH50 complement and C3, C4 levels after 6 months of treatment with IFN-alpha administered to children with chronic hepatitis C suggest that IFN-alpha is capable of reducing complement activity.

Autoimmune hepatitis in the course of chronic HAV--four year observation.

The paper presents a case of a 17-year-old girl with type 1 autoimmune hepatitis in whom biochemical, serological and histopathological markers of chronic hepatitis A were observed for the last 4 years. The diagnosis was based on elevated levels of gammaglobulins, IgG and the presence of autoantibodies (ANA, SMA). At first, the patient was treated with the pulses of corticosteroids and then, as no improvement was observed, continuous steroid therapy was involved. Relatively mild clinical course of the disease and good response to treatment with prednisone were recorded. Our observations suggest that HAV is capable of inducing autoimmune reactions and they indicate possible development of chronic hepatitis A.

[Influence of interferon-alpha therapy on the count and function of T lymphocytes in children with chronic hepatitis C]. / Wplyw leczenia interferonem-alpha na liczbe i funkcje limfocytów T u dzieci chorych na przewlekle zapalenie watroby typu C.

This study aims to assess number and function of T lymphocytes in children with chronic hepatitis persistent C. The study included 60 children with chronic hepatitis C. Among this group 30 were treated with interferon-alpha (INF-alpha) during 6 months. Forty healthy children were included in the study as the control group. We examined subsets of blood lymphocytes T (CD3, CD4, CD8) and lymphocytes with expression of CD3/HLADR, CD3/CD25 antigens using monoclonal antibodies IMK plus and flow cytometry, at the beginning and after 6 months. After INF-alpha therapy a significant increase in subset of CD4 lymphocytes, significant decrease in CD8, increase in CD4/CD8 ratio and increase in lymphocytes with expression CD3/HLADR, CD3/CD25 receptors were observed. Differences in CD8 lymphocytes and CD4/CD8 ratio in the treated children were statistical higher in children with elimination HCV RNA. Applying INF-alpha in children with chronic hepatitis C stimulated immunological response by increasing subsets of CD4 lymphocytes, CD4/CD8 ratio and stimulated lymphocytes.

[Histological evaluation of activity and progression changes in the liver in HCV infected children]. / Ocena nasilenia i zaawansowania zmian w watrobie u dzieci zakazonych HCV.

In this study we present the analysis of pathological pictures of the liver in children with chronic HCV infection, among whom 60 children with HCV RNA and 22 children without HCV RNA were selected. For histological evaluation traditional classification and modified Histological Activity Index (HAI) was used. Only 2 children without viremia did not present changes in histopathological picture, in the remaining ones with and without viremia hepatitis chronic persistent prevailed. In both groups of children statistical differences in necroinflammatory activity and fibrosis were not observed. In histopathological picture correlation grading and staging was observed. The results of the studies show necessity for histological evaluation in anti-HCV carriers, because the pathology of the liver may occur independent of viremia.

[Sources of infections and genotypes of hepatitis C virus in children]. / Zródla zakazenia a genotypy wirusa C zapalenia watroby u dzieci.

The aim of the study was to analyse possible sources of HCV infection as well as to study their relation to specific HCV genotype. The study comprised 60 children with chronic hepatitis C age from 3 to 15 years. In 36.6% of patients, the probable risk factors were surgical interventions or injures; in 60% prior hospitalisation in conservative wards. Surgery was a risk factor in 59% of cases of infection with genotype 1a and in 41%--with genotype 1b. Hospitalisation conservative was the risk factor for the infection in 47% and 50% of cases, respectively.