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.

Abstract

Interferon alpha (IFN-α) is apreferred therapy for antiviral treatment of children with chronic hepatitis B (CHB) aged > 1year currently. Peginterferon alpha-2a (Peg-IFN α-2a) is a recommended international guideline for treatment of CHB children, which is limited to children aged > 3years. But the exact efficacy and safety of IFN-α andPeg-IFN α-2afor treating CHBare 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 weretreated 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 withIFN 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 amedian of48weeks subcutaneously by body surface area (BSA) category at adoseof 3MU/m2 or 104μg/m2, respectively. HBV e antigen (HBeAg) seroconversion rates at 48weeks 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 < 1000IU/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 childrenwith 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.