Virus genotype 1b and long-term response to interferon alpha monotherapy in children with chronic hepatitis C

Mozer‐Lisewska, Iwona; Służewski, Wojciech; Youseif, Khaled Ali; Figlerowicz, Magdalena; Kowala‐Piaskowska, Arleta

doi:10.1007/s00431-002-1147-x

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…Initially, treatment of chronic hepatitis C in children and adolescents was based on an a-interferon monotherapy with multiple dosing regimen yielding an SVR rate from 0% to 76% (27). Nineteen studies using a-interferon have been published between 1992 and 2003 (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). With increasing experience a-interferon monotherapy (injections thrice weekly) showed a rather poor response, and ribavirin was added.…”

Section: Treatment Of Chronic Hepatitis Cmentioning

confidence: 99%

Guidance for Clinical Trials for Children and Adolescents With Chronic Hepatitis C

Wirth

Kelly

Sokal

et al. 2011

J. pediatr. gastroenterol. nutr.

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Most children with chronic hepatitis C are infected vertically, have a low natural seroconversion rate, and carry a lifetime risk of cirrhosis and cancer. Affected children are usually asymptomatic, and histological findings are mild with a low risk of progression, although 5% develop significant liver disease in childhood.The use of combination treatment with pegylated interferon-α and ribavirin has changed the outcome and prognosis for this disease, with approximately 60% of children achieving sustained viral clearance. Combination therapy is not ideal for children because pegylated interferon is administered subcutaneously, impairs growth velocity, and both interferon and ribavirin have significant adverse effects that affect compliance. In addition, approximately 50% of children infected with genotype 1 do not respond to therapy. Thus, additional treatment options are required including improvement in dosing, reduction in the length of treatment, and evaluation of new drugs, such as protease inhibitors, which could be more effective for patients infected with genotype 1.The primary goal of treatment is to eradicate the infection. The future clinical trial design should ensure that any new drugs demonstrate noninferiority to the present standard regimen in both children and adults. The measure for documenting substantial improvement above present therapy should be increased viral clearance rate or the same clearance rate, with a shorter duration of treatment and/or fewer adverse effects. We do not believe there is any need for a placebo arm because approved therapy is available and new treatments can be compared with present therapy.Safety measures should include the standard recommended laboratory investigations, growth parameters, quality-of-life or psychological measures, and a requirement for long-term follow-up for up to 5 years.

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Section: Treatment Of Chronic Hepatitis Cmentioning

confidence: 99%

Guidance for Clinical Trials for Children and Adolescents With Chronic Hepatitis C

Wirth

Kelly

Sokal

et al. 2011

J. pediatr. gastroenterol. nutr.

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show abstract

“…Twenty children received INF-a-2b (3 MU thrice weekly) for 24 weeks; half of the patients exhibited ALT normalization and viraemia disappeared in 20% of cases. These features persisted during the 2-year follow-up, whereas none of the 14 INF untreated controls cleared HCV RNA [47]. Better results have been reported using a combined INF-a-2b and ribavirin therapy for 48 weeks.…”

Section: Hepatitis C Virusmentioning

confidence: 91%

Hepatitis B virus and hepatitis C virus infections in children

Tovo¹,

Lazier²,

Versace³

2005

Current Opinion in Infectious Diseases

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There are doubts as to the long-term persistence of anti-hepatitis B immunization in low-endemicity areas. Routine hepatitis C virus testing in pregnancy is not recommended as there are no available prophylactic measures. Although hepatitis B and C virus infections are usually asymptomatic or with mild manifestations in childhood, concerns around their long-term clinical impact suggest the need for early treatment. Children should preferably be treated in the context of targeted trials for a better understanding of the efficacy and tolerance of drugs currently used in adults.

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Occult hepatitis C: How convincing are the current data?

Welker

Zeuzem

2008

Hepatology

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Virus genotype 1b and long-term response to interferon alpha monotherapy in children with chronic hepatitis C

Abstract: The negative predictive effect of HCV genotype 1b in the course of IFN-alpha treatment may be not valid in children and other features have to be taken into account in the assessment of the efficacy of therapy.

Cited by 6 publications

References 23 publications

Guidance for Clinical Trials for Children and Adolescents With Chronic Hepatitis C

Guidance for Clinical Trials for Children and Adolescents With Chronic Hepatitis C

Hepatitis B virus and hepatitis C virus infections in children

Occult hepatitis C: How convincing are the current data?

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