Interferon- Therapy for Chronic Hepatitis B in Children: A Meta-Analysis
Open Access
- 1 July 1996
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 23 (1) , 131-137
- https://doi.org/10.1093/clinids/23.1.131
Abstract
A meta-analysis of six randomized clinical trials involving 240 children with chronic hepatitis B treated with recombinant interferon-α (IFN-α) was performed. IFN-α treatment was effective in blocking viral replication. Clearance of hepatitis B virus (HBV) DNA from sera occurred in 44 of 127 treated patients (P < .00001),and clearance of hepatitis B e antigen (HBeAg) occurred in seven of 74 treated patients (P = .099). IFN-α normalized serum levels of alanine aminotransferase (ALT) in 33 of 85 treated patients (P = .017). At the end of the follow-up period, viral replication was still reduced in IFN-α-treated patients, HBV DNA clearance occurred in 36 of 126 patients (P = .014), and HBeAg clearance occurred in 29 of 126 patients (P = .026). Regarding these virological and biochemical endpoints, we found that prolonged therapy (>6 months) was associated with a better response, whereas high dosages of IFN-α were not. These findings could be biased by limited follow-up. Children with high ALT levels had a better response. However, these randomized clinical trials had some methodological flaws, including the lack of information on histologic response to IFN-α treatment by pediatric patients and the absence of “hard outcomes” (such as survival or development of cirrhosis or hepatocellular carcinoma).Keywords
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