慢性乙肝病毒感染儿童的自然历史和干扰素治疗的疗效

StephenW

Natural history of chronic hepatitis B virus infection in childhood and efficacy of interferon therapy

Posted online on April 10, 2015. (doi:10.3109/00365521.2014.962075)

  

Tomoko Takano, Hitoshi Tajiri, Yuri Etani, Yoko Miyoshi, Yasuhito Tanaka, and Stephen Brooks
1Department of Pediatrics, Osaka General Medical Center, Osaka, Japan
2Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
3Department of Pediatrics, Osaka University Hospital, Suita, Japan
4Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
5Department of Microbiology/Immunology, State University of New York, Buffalo, NY, USA
Correspondence: Tomoko Takano, Department of Pediatrics, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-ku, Osaka
, Japan. +81 6 6692 1201. +81 6 6695 3559. [email protected]


Abstract

Objectives. In short-term observations, interferon (IFN) therapy has been shown to be effective in producing both biochemical and virological responses in children with chronic hepatitis B virus (HBV) infection. However, in long-term follow up, no studies have shown a clear advantage of IFN therapy during childhood. We conducted a retrospective study on the sustained effect of IFN therapy among a Japanese pediatric population. Methods and subjects. A retrospective study was performed on 155 children with chronic HBV infection who were followed in two affiliated hospitals during the period from 1986 to 2013. Results. The 155 patients comprised 97 males and 58 female. Infection route was maternal transmission in 96/155 patients. HBV genotype was A in 17, B in 6, and C in 51 patients. IFN therapy was performed in 48 patients. One year after the completion of IFN therapy, normalization of alanine aminotransferase (ALT) and lower viral levels (<104 copies/ml) was observed in 43 and 29 patients, respectively. The sustained effects of IFN therapy were evaluated by comparison between 43 hepatitis B e-antigen (HBeAg)-positive patients treated with IFN and 67 patients with chronic hepatitis B observed without IFN therapy. A Cox’s proportional hazard analysis showed a higher seroconversion rate in the IFN group than in the untreated group (p = 0.003). Similarly, there were higher rates of ALT normalization and lower viral levels in the IFN group than in the untreated group (p = 0.001 for both). Conclusion. IFN therapy showed sustained effects for achieving ALT normalization and HBeAg seroconversion and for reducing the viral load in children with chronic hepatitis B.
Keywords
childhood, chronic hepatitis B, interferon therapy, long-term effect, natural history


Read More: http://informahealthcare.com/doi/abs/10.3109/00365521.2014.962075

StephenW

慢性乙肝病毒感染儿童的自然历史和干扰素治疗的疗效

在线发表于4月10日，2015年（DOI：10.3109 / 00365521.2014.962075）

  

高野智子，仁志田尻，尤里Etani，洋子三好，田中保仁和斯蒂芬·布鲁克斯
儿科，大阪综合医疗中心，大阪，日本教研室
2Osaka医疗中心和研究所孕产妇和儿童健康，和泉，日本
儿科，大阪大学附属医院，吹田，日本3Department
病毒学4Department和肝单位，医学科学名古屋市立大学研究生院，日本名古屋
微生物学/免疫学，纽约州立大学，布法罗，纽约，美国5Department
函授：高野智子，儿科，大阪综合医疗中心，56年3月1日Bandaihigashi，住吉区系
，日本。 +81 6 6692 1201 +81 6 6695 3559. [email protected]


抽象

目标。在短期观察，干扰素（IFN）治疗已被证明是有效的生产在儿童慢性乙型肝炎病毒（HBV）感染生化和病毒学反应。然而，在长期随访，没有研究显示儿童时期的IFN疗法的一个明显的优势。我们对干扰素治疗的日本小儿科人口的持续作用进行了回顾性研究。方法和科目。 155儿童慢性HBV感染者谁是后面的两所附属医院期间，从1986年至2013年业绩进行回顾性研究。在155例患者包括97名男性和58女。感染途径是一百五十五分之九十六患者产妇传输。 HBV基因型为A 17，B 6，和C在51例。在48例患者进行干扰素治疗。一年完成干扰素治疗，谷丙转氨酶（ALT）和较低的病毒水平正常化后（<104拷贝/ ml），观察在43和29例，分别为。 IFN治疗的效果持续43乙型肝炎e抗原（HBeAg）阳性阳性与干扰素治疗，67例慢性乙型肝炎无干扰素治疗观察患者之间的比较进行了评价。的Cox比例风险分析，表现出较高的血清转换率的IFN组比未治疗组（p = 0.003）。同样，有ALT复常率较高和较低的病毒水平的IFN组比未治疗组（P = 0.001两者）。结论。干扰素治疗表现出持续的效应实现ALT正常化和HBeAg血清学转换和减少儿童慢性乙型肝炎的病毒载量
关键词
童年，慢性乙型肝炎，干扰素治疗，长期的效果，自然历史