Interferon induction regimen for chronic hepatitis C genotype 4 in Egyptian children

Abstract

Chronic hepatitis C has been described as a mild disease in children, but fibrosis progression and end stage liver disease have been documented. Thus, the problem of therapy has become a challenging issue. Our preliminary results using the standard treatment regimen of alternate day interferon (IFN) plus ribavirin yielded 21.4% sustained virological response (SVR). In this study, we evaluate the efficacy and safety of daily IFN alpha-2a induction regimen plus ribavirin in treatment of children with chronic hepatitis C genotype 4. The study included 40 children with chronic hepatitis C. Thirty patients were naive hepatitis C and 10 were previously non-responders to the standard treatment regimen. All children were assigned to receive daily IFN plus ribavirin for 1 month, then alternate day IFN plus ribavirin for 11 months. The mean age of children was 11.7 ± 0.35 years and 27 (67.5%) were males. Twenty-nine (72.5%) had low, three (7.5%) moderate and eight (20%) high viremia. Thirty-four (85%) had rapid virological response and 33 (82.5%) had SVR. One patient had a breakthrough at 6 months duration of therapy. Adverse effects were mild, and were not treatment limiting. Low viral load was significantly associated with higher rate of SVR. Rapid virological response had 90% positive predictive value for subsequent SVR with 100% sensitivity. Daily IFN induction regimen showed a high efficacy and safety for treatment of children with chronic hepatitis C virus genotype 4.

Keywords

Chronic hepatitis C - interferon - ribavirin - liver disease