Long‐term benefits of interferon‐α therapy in children with HBeAg‐positive immune‐active chronic hepatitis B

Abstract

The long‐term benefits of interferon‐α (IFN‐α) treatment in children with chronic hepatitis B (CHB) remain unclear. We conducted a retrospective and real‐world study to evaluate the safety and long‐term clearance rates of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) in CHB children who received IFN‐α monotherapy for 72 weeks and were with 13‐year follow‐up visit. Participants treated with IFN‐α (n = 316) were more likely to become HBeAg negatve (39.87% vs. 27.37%; p < .05) and HBsAg negative (11.08% vs. 3.16%; p < .05) by the end of the treatment period than untreated participants (n = 95). Treated participants also had higher cumulative rates of HBeAg loss (74.13% vs. 59.27%; p < .05) and HBsAg loss (46.95 vs. 33.11%; p < 0.05) than untreated participants in parallel by the end of 13‐year follow‐up. In particular, the cumulative rate of HBsAg loss was higher in treated children aged 1–7 years than in those aged 8–17 years (71.40% vs. 39.0%; p < .01). Children who were HBeAg‐negative at the end of IFN‐α treatment or who had serum alanine aminotransferase levels of ≥80 IU/L at baseline were likely to have higher cumulative HBsAg loss rates. Accordingly, HBeAg loss at 72 weeks was positively associated with the cumulative HBsAg loss rate in untreated children. There were no serious adverse events of IFN‐α therapy for the treated patients throughout the study period. Overall, IFN‐α therapy was effective in obtaining higher long‐term cumulative rates of HBeAg and HBsAg loss in children with HBeAg‐positive immune‐active CHB, especially among those aged 1–7 years.

Frequent alanine aminotransferase flares and promising antiviral therapy efficacy during the preschool age: An opportunity to achieve HBsAg loss in children with mother‐to‐child transmitted hepatitis B

“…Our findings confirmed a relatively high HBsAg loss rate of 36.4% (4/11) in the IFN‐based therapy group after a median follow‐up of 28.0 months. The rate falls into the reported ranges of 8.9%–83% with IFN‐based therapy after a maximum follow‐up of 13 years 12–14,26,27 . Whereas the effects of NAs are less studied.…”

“…In the present study, we did not find a similar result. This inconsistency may be due to the small sample size since Wang et al 14 also found no significant difference between ALT groups in 65 children aged 1–7 years. Alternatively, other factors such as entecavir used in this study may contribute to the difference.…”

“…Nevertheless, we provided a new insight for a future large prospective study. In addition, Wang et al 14 previously reported that children with higher baseline ALT levels (≥80 IU/L) indicated higher cumulative rates of HBsAg loss. In the present study, we did not find a similar result.…”

“…For decades, there has been a conservative therapeutic approach in children because of a long‐held belief that HBV infection in children remains in an immune‐tolerant phase, 8,9 characterized by normal serum alanine aminotransferase (ALT) and high concentrations of HBV DNA, and hardly responds to antiviral treatment 10,11 . Recently, evolving evidence suggests that antivirals have shown favorable effects in children with immune‐active CHB 12–14 . Besides, the combination of nucleos(t)ide analogues (NAs) and interferon (IFN) can also increase the HBsAg loss rate in children with immune‐tolerant CHB 15–17 .…”

Possible internal viral shedding and interferon production after clinical recovery from COVID-19: Case report

“…Interferon therapy causes several side effects ( 7 , 8 ). We noticed that IFN administration and post-COVID syndrome cause similar symptoms ( 2 ), including fatigue, exhaustion, weakness, dizziness, hair loss, loss of appetite, heart palpitations, depression, anxiety, high temperature, joint pain, diarrhea, stomachache, cough, headaches, sore throat, and skin rashes.…”