[Preliminary results of interferon alpha-2a and lamivudine combination therapy regimen in children with chronic hepatitis B]

Abstract

The combination therapy regimen of interferon (IFN)-alpha and lamivudine (LAM), a nucleoside analogue, is lately in use in chronic hepatitis B (CHB) infections. The aim of this study was the evaluation of the efficacy of IFN-alpha 2a and LAM combination therapy in children with CHB infection. Twenty-seven cases (mean age 10.4 +/- 3.7 years, 20 males) who were followed up between 2002 and 2005 in Pediatric Gastroenterology Department, were included in the study. IFN-alpha 2a (5 MU/m2 SC, three times a week for 6 months) and LAM (4 mg/kg/d PO, maximum 100 mg/d for one year) were given simultaneously. LAM medication was extended to two years in non-responders. Alanine aminotransferase (ALT) levels, hepatitis markers and HBV-DNA were monitored once in three months. "Partial" response was defined as normal levels of ALT and negative HBV-DNA, and "complete" response was defined as seroconversion of HBeAg/anti-HBe. The cases whose HBV-DNA not getting negative and whose ALT levels did not decrease to the normal values were defined as "non-responders". In our study, one case (4.3%) was found non-respondant, "partial" response was seen in 13 (56.5%) cases, whereas "complete" response was seen in 9 cases (39.1%) out of 23 cases who have got the medications as long as a year. There was no significant difference between the response to the therapy regimen and the age, sex, ALT levels, hepatic activity indices (HAI) and HBV-DNA levels (p>0.05). As a result, IFN-alpha 2a and LAM combination therapy regimen is an effective alternative therapy in childhood, and the efficacy of the therapy was not influenced by age, sex, initial ALT levels, HBV-DNA and HAI in our study group.