| Clinical and Histologic Changes in Children with Chronic Hepatitis B Virus Infection after Alpha Interferon Therapy |
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Kyung Mo Kim, Soo Jong Hong, Young Seo Park, Hyung Nam Moon, Chang Yee Hong, Joo Ryoung Huh |
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Department of Pediatrics, College of Medicine University of Ulsan, Seoul, Korea |
| 소아 만성 B형 간염 환자에서 알파 인터페론의 치료 효과- 임상 및 조직학적 변화 소견 |
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김경모, 홍수종, 박영서, 문형남, 홍창의, 허주령 |
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울산대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Several trials in children for chronic hepatitis B have shown the efficacy of alpha interferon in eliminating hepatitis B virus replication, accompanied by an improvement in the liver cell damage. But reports about the alpha interferon therapy are rare in Korean children and there is no report about histologic changes even with adult. So we tried to evaluate the changes in serologic markers, transaminase levels and histology in Korean children with chronic hepatitis B virus infection. We also observed the side effects of the alpha interferon therapy.
Methods
: Eight children with chronic hepatitis B received 3 million units of recombinant alpha interferon 2b subcutaneously, three times a week for 6 months. Pre and post treatment liver biopsies were performed in 6 patients, and modified histologic activity index were determined respectively. HBsAg, HBsAb, HBeAg, HBeAb and HBV DNA and transaminase level were assessed serially. Side effects of alpha interferon therapy were also checked.
Results
: 1) Serological and biochemical responses were noted in six (75%) among 8 children. One case of recurrence was noticed at 8 months after the therapy. Disappearance of HBsAg was not observed.
2) Pretreatment modified histologic activity index was higher in responders (modified HAI=10.8) compared with that in nonresponders (modified HAI=3.5). But it is not statistically significant (p=0.06).
3) Histologic changes in responders were significant. The changes in periportal necrosis and portal inflammation were prominent after treatment while those of lobular necrosis and fibrosis were not.
4) Remarkable decrease in the numbers of hepatocyte stained immunohistochemically by HBV core antigen was noted in responders after alpha interferon therapy.
5) Flu like symptoms were noted in all children but most of which disappeared within 1 or 2 weeks of therapy. Hair loss was noted in one child, but recovered after discontinuation of the therapy.
Conclusion
: This results indicate that alpha interferon is effective in inducing a serological, biochemical and histological improvement in six(75%) out of 8 children with chronic hepatitis B. There is no remarkable side effect. In conclusion, alpha interferon is safe and effective method of treatment in children with chronic hepatitis B. |
| Key Words:
Chronic hepatitis B, Alpha interferon treatment, Histology, Immunohistochemistry, Children |
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