Comparison of treatments of chronic hepatitis B in children with lamivudine and α‐interferon combination and α‐interferon alone

Dikici, Bünyamin; Boşnak, Mehmet; Boşnak, Vuslat; Dagli, Abdullah; Davutoğlu, Mehmet; Yağcı, Raşit Vural; Haspolat, Kenan

doi:10.1046/j.1442-200x.2002.01607.x

Cited by 22 publications

(19 citation statements)

References 23 publications

(21 reference statements)

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“…Combination therapies using different doses and time schedules of interferon a and lamivudine have been investigated in several studies [56][57][58][59][60][61][62][63][64]. These studies mostly involved small numbers of patients and yielded controversial results.…”

Section: Combination Therapymentioning

confidence: 99%

Natural history and clinical management of chronic hepatitis B virus infection in children

Chang

2008

Hepatol Int

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Hepatitis B virus (HBV) infection may cause acute, fulminant, or chronic hepatitis, leading to liver cirrhosis or hepatocellular carcinoma. Despite the availability of effective vaccine, HBV infection during infancy or early childhood is common in areas of high endemicity. In these regions, mother-to-infant transmission accounts for approximately 50% of chronic infections. Although the natural history of HBV infection in adults is well characterized, little information is available in the literature regarding the natural history of HBV infection in children. Similar to infection in adults, chronic HBV infection in children can be divided into distinct phases: immune tolerant, immune clearance, and inactive carrier state. However, acute exacerbation, with reactivation of HBV replication and re-elevation of alanine aminotransferase levels after hepatitis B e antigen seroconversion, is relatively rare in children, in comparison to adults. Although several potent antiviral agents are now available for the treatment of chronic hepatitis B, experience with these agents in the pediatric setting is limited. To date, conventional interferon alpha and lamivudine are the only two antiviral agents approved to treat chronic hepatitis B in children. The rapid emergence of resistant HBV associated with long-term lamivudine therapy, as well as poor tolerability associated with conventional interferon alpha, are factors that should be considered before initiating antiviral therapy. This article reviews current knowledge regarding the natural history and treatment of chronic hepatitis B in children. Factors that affect the natural history of HBV infection in children are also reviewed.

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Section: Combination Therapymentioning

confidence: 99%

Natural history and clinical management of chronic hepatitis B virus infection in children

Chang

2008

Hepatol Int

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“…Other nucleoside analogues (like adefovir) used in the treatment of adult patients with chronic hepatitis, are not widely accessible for pediatric patients [16,17] . Data on the results of combined IFN-α and lamivudine therapy vary [18][19][20][21] , seem no more effective than monotherapy with either IFN-α or lamivudine.…”

Section: Discussionmentioning

confidence: 99%

501 Lamivudine therapy in children with chronic hepatitis B

Liberek¹,

Szaflarska-Popławska²,

Korzon³

et al. 2006

Journal of Hepatology

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“…Dikici et al [15] found that 12 months of combination therapy was associated with higher rates of ALT normalization and clearance of HBV DNA, compared with IFN alone; however, the complete response rate (HBeAg/antiHBe seroconversion plus clearance of HBV DNA plus normalization of ALT) 6 months after cessation of therapy did not differ between groups.…”

Section: Treatment For Hepatitis B Virusmentioning

confidence: 98%

Pediatric issues in new therapies for hepatitis B and C

Schwarz

2003

Curr Gastroenterol Rep

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Two antiviral treatments have been approved for hepatitis B virus (HBV) infection by the US Food and Drug Administration (FDA) for use in children: interferon (IFN)-alpha, 6 MU/m(2) three times a week subcutaneously for 6 months, and lamivudine, 3 mg/kg/d orally for 12 months. Twenty-six percent to 58% of children treated with IFN become HBV DNA negative, and up to 38% become negative to hepatitis B e antigen (HBeAg). Lamivudine, a nucleoside analogue that blocks viral replication by inhibition of the HBV polymerase, has been associated with comparable rates of seroconversion of HBeAg to anti-HBe. Loss of surface antigen occurs in less than 5% of patients treated with lamivudine, compared with 3% to 33% in those treated with IFN-alpha. Fifty percent to 65% of children treated with lamivudine clear HBV DNA after 12 months of therapy, but relapse rates have not been clarified. Patients treated with lamivudine develop drug-resistant (YMDD) mutants in the HBV polymerase at the rate of 16% to 32% per year. No treatments for children with hepatitis C virus (HCV) have been approved by the FDA. However, published reports describe treatment with IFN monotherapy and combination therapy with IFN and ribavirin. Trials of PEG-IFN alone or in combination with ribavirin are in progress. Given the lack of data regarding treatment of HCV in children, it is generally agreed among pediatric hepatologists that the optimal treatment is within the context of randomized, controlled trials.

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Comparison of treatments of chronic hepatitis B in children with lamivudine and α‐interferon combination and α‐interferon alone

Cited by 22 publications

References 23 publications

Natural history and clinical management of chronic hepatitis B virus infection in children

Natural history and clinical management of chronic hepatitis B virus infection in children

501 Lamivudine therapy in children with chronic hepatitis B

Pediatric issues in new therapies for hepatitis B and C

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