Lamivudine and high-dose interferon alpha 2a combination treatment in naive
HBeAg-positive immunoactive chronic hepatitis B in children: an East
Mediterranean center's experience.
Yilmaz A, Akcam M, Gelen T, Artan R.
Pediatric Gastroenterology, Akdeniz University, Pediatri Anabilim Dali,
Arapsuyu, Antalya, 07059, Turkey, [email protected].
Chronic hepatitis B virus infection is among the most common causes of
chronic liver disease in children. The aim of this study was to document
prospectively our experiences related to lamivudine and high-dose
interferon-alpha2a combination in naive, e antigen positive, chronic
hepatitis B virus infection treatment in children. Thirty-three children
diagnosed as naive, immunoactive chronic hepatitis B were treated with
lamivudine (3 mg/kg/day) and interferon-alpha2a (10 MU/m(2), thrice weekly).
Initially, lamivudine was initiated three months before interferon-alpha for
induction, and after June 2002, both drugs were started simultaneously.
After interferon-alpha was stopped, lamivudine alone was continued for six
months. HBeAg seroconversion with the normalization of serum ALT was
achieved at the end of treatment and at the end of follow-up for 20/33
patients. Initial mean alanine aminotransferase, 142.9 IU/L, decreased to a
mean value of 31.4. End-treatment response and sustained response rates were
66.7% (14/21) and 50% (6/12), respectively, in patients that underwent
lamivudine induction before interferon-alpha and in patients that began to
receive the two drugs simultaneously (p=0.4). Flu-like syndrome and anorexia
were the most common complaints. As our conclusions, we propose that
interferon-alpha2a plus lamivudine combination therapy is highly successful
and safe in children suffering from chronic hepatitis B. Lamivudine
induction before interferon does not seem to be necessary.
PMID: 16944240 [PubMed - as supplied by publisher]
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发表于 2006-9-20 17:13
