Efficacy of interferon in treating chronic hepatitis C in children with a history of acute leukemia

Abstract

Interferon (IFN) is effective in treating adults as well as children with chronic hepatitis C. We investigated the efficacy of IFN therapy in 13 children with underlying acute leukemia who had chronic hepatitis C (age range, 5 to 17 years; mean age, 9.9 years). Natural IFN- alpha was administered at a dose of 0.1 mega unit (MU)/kg (maximum dose, 6.0 MU) daily for 2 weeks and then three times per week for an additional 22 weeks (total dose, 8 MU/kg). IFN treatment was initiated at least 2 years after the completion of treatment for acute leukemia. A complete response was obtained in 5 children (38%). The serum level of anti- hepatitis C virus core antibody was closely related to the response to IFN. IFN therapy was well tolerated by all but 1 of the children, who developed mild transient heart failure 4 months after the initiation of therapy. IFN therapy for children with chronic hepatitis C who had underlying acute leukemia was beneficial. However, further trials are required to confirm the safety and improve the dosage schedule of IFN therapy.

Effects of pegylated interferon‐α‐2a monotherapy on growth in Japanese children with chronic hepatitis C

“…In our previous study, which evaluated conventional IFN treatment efficacy for children with transfusion-acquired CHC, most of the genotypes were genotype 1. 13 Therefore, a higher rate of genotype 2 in children may be a feature of mother-to-child transmission in Japan. Second, this study adopted a relatively higher dose of PEG IFN-a-2a, and the increase in dose was based on viral response.…”

“…F ROM MARCH 2005 to April 2011, 31 children (19 boys, 12 girls; median age, 6 years; range, [3][4][5][6][7][8][9][10][11][12][13][14] were treated with PEG IFN-a-2a monotherapy at our single center. They were all infected through mother-tochild transmission and were all treatment naive.…”

Efficacy of pegylated interferon‐α2a monotherapy in Japanese children with chronic hepatitis C

“…Conventional IFN monotherapy in children gives an SVR rate of 33-45% (26% in genotype 1, 70% in other genotypes), which is much better than the rate of 19% observed in adults. [23][24][25] The better response rate in children may be the result of the short time between HCV infection and treatment, the relatively higher dose of IFN and lack of comorbid diseases. 10,26 An SVR rate of approximately 30% is obtained with PEG IFN monotherapy in adults.…”

“…10 Three of eight patients with genotype 1 achieved SVR, and this rate was not so high compared to conventional IFN monotherapy for 6 months, as we previously described (43% vs 40%). 25 A recently published abstract from the Peds-C trial showed an SVR rate with PEG IFN monotherapy of only 21%. 27 Therefore, SVR rates in children show little or no difference between conventional IFN monotherapy and PEG IFN monotherapy, whereas a significant difference is observed in adult cases.…”

Children with hepatitis C

“…43 Even though the studies included several types of patients, and different dosages, schedules and types of interferon were used, the sustained virological response rates, when reported, were remarkably similar among the studies, ranging from 33% to 45%. 29,[44][45][46][47][48][49][50][51] These sustained virological response rates are significantly higher than those reported in large trials of interferon monotherapy in adult patients. A systematic analysis of these heterogeneous studies was recently reported.…”