engleski

Long-term outcome of interferon treatment in chronic HBV infection

Aim: To provide additional data of long term outcome in children treated for chronic HBV infection with interferon. Patients: 34 patients with previously diagnosed chronic HBV infection were asked whether they want to be enrolled in treatment study or not. 10 were just followed-up and 24 were treated with 5 million IU / square meter subcutaneously 3 times a week for 6 months. All patients met established criteria for chronic HBV infection. 4 outcomes were assessed for each patient: 1. sustained viral response (SVR) - permanent loss of HBV DNA, 2. serologic response(SR) - loss of HBeAg and anti HBe positive antibodies, 3. complete serologic response (CSR) - loss of HBsAg and anti HBs positive antibodies, 4. biochemical response (BR)- (normalization of ALT values and ALT/AST ratio) at: a) the end of treatment-EOT, b) 2 yrs after treatment- 2YAT, and c) during last outpatient visit-LOV (30 mthsY8.7 yrs after EOT). Results: All patients were followed for 78.5 patient yrs before treatment and 90.8 yrs after treatment (mean 3 yrs and 11 mths). 20 had wild type hepatitis B, a 4 were pre-core type. 23 patients finished treatment. At the EOT SVR was achieved in 7 patients, SR was achieved in 2 with wild type hepatitis B, CSR in 1, and BR in 13. At the 2YAT SVR was achieved in 8, SR was achieved in 7 of 19 patients, CSR in 1 as at the EOT. BR was sustained in 13. All 4 patients with pre-core mutation had SVR (100%) which is odd. 4 out of 19 with wild type had SVR (21.1%), and additional 3 besides 4 with SVR had also SR. More successful treatment of patients with pre- core mutation (chi square, p=0.017) is unexpected finding. At the 2YAT 11 patients (47.8%) fulfill the criteria of successful treatment. 1 (wild type) out of 10 patients who received no treatment achieved SVR and SR after follow up of 59.3 yrs (5.9 yrs per patient). We have found favorable outcome in our youngest 13 patients (diagnosed before 5th birthday): 4 SVR and 6 SR. At LOV 8 patients had SVR (not the same 8, meanwhile 2 had relapsed, and 2 new became negative. There were 9 patients out of 19 with SR, 1 with CSR, 15 with BR. Conclusion: It takes longer follow up to fully appreciate effects of treatment.

HBV infection ; long-term outcome ; children

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