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
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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.
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.
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.
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.
KeywordsAntiviral therapy Children Chronic hepatitis B Interferon alpha Pegylated interferon alpha
We appreciate all the staff who helped and supported this study and we are grateful for all the participating children and their parents.
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.
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
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.
- 3.Wang GQ, Wang FS, Cheng J, Ren H, Zhuang H, Sun J, et al. Guidelines for treatment of chronic hepatitis B (2015). Chin J of Exp Clinic Infect Dis (Electron Ed). 2015;33:570–89.Google Scholar
- 5.EASL. EASL Clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;2017:370–98.Google Scholar
- 7.Sokal EM, Paganelli M, Wirth S, Socha P, Vajro P, Lacaille F, et al. Management of chronic hepatitis B in childhood: ESPGHAN clinical practice guidelines: consensus of an expert panel on behalf of the European society of pediatric gastroenterology Hepatology and Nutrition. J Hepatol. 2013;59:814–29.CrossRefGoogle Scholar
- 24.Zhu SS, Dong Y, Wang LS, Xu ZQ, Chen DW, Gan Y, et al. A retrospective study on the liver pathological characteristics and the effect of antiviral treatment for 1–7 years old children with heptitis B e antigen negative chronic hepatitis B. Chin J Pediatr. 2016;54:587–91.Google Scholar
- 25.Zhuang H, Weng XH. Drug resistance and management of nucleoside and nucleotide drugs for chronic hepatitis B treatment. Chin Prev Med. 2013;33:1–11.Google Scholar