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Efficacy and safety of interferon alpha-2b versus pegylated interferon alpha-2a monotherapy in children with chronic hepatitis B: a real-life cohort study from Shanghai, China

  • Yao Hu
  • Ying-Zi Ye
  • Li-Jing Ye
  • Xiao-Hong Wang
  • Hui YuEmail author
Original Article
  • 24 Downloads

Abstract

Background

Interferon alpha (IFN-α) is a preferred therapy for antiviral treatment of children with chronic hepatitis B (CHB) aged > 1 year currently. Peginterferon alpha-2a (Peg-IFN α-2a) is a recommended international guideline for treatment of CHB children, which is limited to children aged > 3 years. But the exact efficacy and safety of IFN-α and Peg-IFN α-2a for treating CHB are not sufficient.

Methods

Clinical manifestations, baseline characteristics, related laboratory tests and adverse events were retrospectively analyzed in children with CHB, who visited Children’s Hospital of Fudan University and were treated with IFN α-2b or Peg-IFN α-2a monotherapy and followed up from January 2003 to October 2018.

Results

A total of 36 immune-active patients without advanced fibrosis were enrolled to be treated with IFN α-2b (group A, n = 18) or Peg-IFN α-2a (group B, n = 18). IFN α-2b or Peg-IFN α-2a was administered for a median of 48 weeks subcutaneously by body surface area (BSA) category at a dose of 3 MU/m2 or 104 μg/m2, respectively. HBV e antigen (HBeAg) seroconversion rates at 48 weeks post-treatment were higher in group A than group B (92.9% vs. 87.5%), so as the rates of HBsAg clearance (22.2% vs. 11.1%), and hepatitis B virus (HBV)-DNA < 1000 IU/mL (88.9% vs. 83.3%). Only mild flu-like symptoms and transient neutropenia appeared in some children at the early stage of treatment. No severe abnormal results was observed in other laboratory assessments.

Conclusion

The antiviral monotherapy of 48-week IFN α-2b or Peg-IFN α-2a in children with CHB is well tolerated and effective, which is associated with higher rates of HBeAg seroconversion and HBsAg clearance than in adults and previously pediatric patients.

Keywords

Antiviral therapy Children Chronic hepatitis B Interferon alpha Pegylated interferon alpha 

Notes

Acknowledgements

We appreciate all the staff who helped and supported this study and we are grateful for all the participating children and their parents.

Author contributions

HY conceptualized and designed the study, interpreted the results of the analyses, and critically reviewed and revised the manuscript. YH assisted with the study design, collected the data, drafted the initial manuscript, conducted the initial analyses, assisted with the interpretation of results, and reviewed and revised the manuscript. YZY, LJY, XHW assisted with the study design, designed the data collection instruments, coordinated and supervised data collection, assisted with the interpretation of results, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Funding

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Compliance with ethical standards

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

All the authors declare no conflict of interest.

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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  1. 1.Department of Infectious DiseasesChildren’s Hospital of Fudan UniversityShanghaiChina

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