Abstract
Chronic hepatitis C has been described as a mild disease in children, but fibrosis
progression and end stage liver disease have been documented. Thus, the problem of
therapy has become a challenging issue. Our preliminary results using the standard
treatment regimen of alternate day interferon (IFN) plus ribavirin yielded 21.4% sustained
virological response (SVR). In this study, we evaluate the efficacy and safety of
daily IFN alpha-2a induction regimen plus ribavirin in treatment of children with
chronic hepatitis C genotype 4. The study included 40 children with chronic hepatitis
C. Thirty patients were naive hepatitis C and 10 were previously non-responders to
the standard treatment regimen. All children were assigned to receive daily IFN plus
ribavirin for 1 month, then alternate day IFN plus ribavirin for 11 months. The mean
age of children was 11.7 ± 0.35 years and 27 (67.5%) were males. Twenty-nine (72.5%)
had low, three (7.5%) moderate and eight (20%) high viremia. Thirty-four (85%) had
rapid virological response and 33 (82.5%) had SVR. One patient had a breakthrough
at 6 months duration of therapy. Adverse effects were mild, and were not treatment
limiting. Low viral load was significantly associated with higher rate of SVR. Rapid
virological response had 90% positive predictive value for subsequent SVR with 100%
sensitivity. Daily IFN induction regimen showed a high efficacy and safety for treatment
of children with chronic hepatitis C virus genotype 4.
Keywords
Chronic hepatitis C - interferon - ribavirin - liver disease
