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Factors Predictive of Response to Interferon-α Therapy in Children with Chronic Hepatitis B

Journal of the Korean Pediatric Society 2000;43(4):514-519.
Published online April 15, 2000.
Factors Predictive of Response to Interferon-α Therapy in Children with Chronic Hepatitis B
Hong Kwon Kim1, Bo Hwa Choi1, Kyung Mo Kim1, Kyung Hoon Kang2, In Seok Lim3, Eung Sang Choi3
1Department of Pediatrics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
2Department of Pathology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
3Department of Pediatrics, College of Medicine, Chung Ang University, Seoul, Korea
만성 B형 간염 환아에서 interferon-alpha 치료의 반응 예측 인자 분석
김홍권1, 최보화1, 김경모1, 강경훈2, 임인석3, 최응상3
1울산대학교 의과대학 서울중앙병원 소아과
2울산대학교 의과대학 서울중앙병원 진단병리과
3중앙대학교 의과대학 소아과학교실
Abstract
Purpose
: The efficacy and safety of interferon-alpha(IFN-α) therapy in children with chronic hepatitis B(CHB) is similar to that of adults. However, little information is available about the predictive factors of response to this therapy in children. The aim of this study was to determine the predictive factors for responsiveness to IFN-α therapy in children with CHB.
Methods
: The basal parameters were studied in 35 children with CHB treated with IFN-α(300 MU/m2 of body surface area subcutaneously, 3 times weekly for 6 months). HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA and aminotransferase levels were assessed serially. Pretreatment liver biopsies were performed in 16 patients and modified histologic activity index(HAI) was determined respectively. Responder was defined as disappearance of HBeAg and HBV-DNA after cessation of therapy. We analyzed the predictive factors of response to IFN-α therapy.
Results
: Serum HBeAg and HBV DNA became negative in 16 children(46%) among 35 treated children at the time of cessation of therapy. In the univariate analysis, HAI, ALT level and maternal HBsAg were associated with the response. In multivariate analysis, HAI was the best factor for predicting response(sensitivity : 80% and specificity : 100%).
Conclusion
: Factors predictive of response in children with CHB are similar to those reported in adult, and may help identify those children with a better chance of responding.
Key Words: Interferon-alpha, Child, Hepatitis B, Predictive value


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