Virological response to treatment with peginterferon alfa-2a in adolescents with chronic hepatitis B.

BACKGROUND: There are few data on the efficacy and safety of pegylated interferon treatment in adolescents with chronic hepatitis B. AIM: We conducted a pilot study in 13 adolescents with chronic hepatitis B treated with peginterferon alfa-2a at 100 µg/m(2) once weekly for 48 weeks. METHODS: HBV DNA was assessed by qPCR method. RESULTS: After four weeks of treatment six adolescents had undetectable HBV DNA (<12 IU/mL). Seven adolescents--including five HBV negatives at week 4--had undetectable HBV DNA (<55 IU/mL) at week 24, and seven adolescents--including all HBV DNA negatives at week 4--had undetectable HBV DNA at week 48 of treatment (<55 IU/mL). Five adolescents had undetectable HBV DNA (<55 IU/mL) after 24 weeks of follow-up (sustained viral response). HBeAg seroconversion was achieved in one patient. HBsAg loss was documented at the end of therapy in two of the six adolescents HBV DNA negative at week 4 of treatment. Three adolescents withdrew from the treatment (two because of adverse events, one because of withdrawal of parental consent). Leukopenia was reported in seven adolescents and three individuals experienced thrombocytopenia. Except for one patient who discontinued treatment due to leukopenia, no dose modifications for adverse events or laboratory abnormalities were required. CONCLUSION: This pilot study shows that 48 weeks of treatment with peginterferon alfa-2a can result in sustained HBV DNA suppression, HBeAg seroconversion and HBsAg loss in adolescents with CHB. Larger and longer trials are now required to better define the magnitude of the benefit in this group of patients.

[Efficacy of retherapy of chronic hepatitis C in children--own observation]. / Skutecznosc reterapii przewleklego zapalenia watroby typu C u dzieci--obserwacje wlasne.

UNLABELLED: The aim of the study was an assessment of retherapy in children with chronic hepatitis C. Investigations were performed in 41 children divided on 2 groups (A and B). Children from group A were treated firstly with IFN monotherapy during 6 months and as retherapy they administered combined therapy with IFN alpha and ribavirin during 12 months. Patients from group B were firstly treated with combined IFN alpha and ribavirin therapy during 12 months and as retherapy with pegylated IFN and ribavirin. Sustained viral response achieved 44% of children (58% from group A and 33% from group B). ALT activity normalization was observed in 46% of treated children (53% from group A and 45% from group B). Prevalence of relapses in group A and B was 14% and 37% respectively. Among children who responded on treatment, baseline ALT activity was statistically significant higher in group A (p<0.05). The age of children from this group was statistically significant lower in comparison with children from group B (p<0.02). Mean leukocytes count after 3 months of treatment was statistically significant lower in children treated with pegylated IFN and ribavirin (p<0.02). CONCLUSIONS: Retherapy of chronic hepatitis in children was effective and well tolerated. The high frequency of relapses seems to be a point of extending of retherapy.

[Q fever--case report]. / Opis przypadku goraczki Q.

This work presents a case of Q fever in a 55-year-old man who came back from Lebanon. The dominant symptoms of the disease were fever and dry cough and in physical testing fine rales at the bottom of the right lung. An epidemiologic investigation (a monthly stay in Lebanon) and a serologic testing (indirect immunofluorescence assay) were useful to confirm a diagnosis of Q fever. Moreover the authors of the work paid attention to the differential diagnosis of Q fever and effectiveness of tetracycline in the treatment. The basic methods of the prevention of the disease were also described. In the case of a fever in individuals coming back from the region of the Mediterranean Sea Q fever should be taking into consideration in the differential diagnosis.