Abstract

Chronic hepatitis B virus infection in children is a progressive disease. The efficacy of recombinant interferon alpha in the treatment of chronic viral hepatitis B in children is still inconclusive. We evaluated the efficacy of interferon alpha 2a on 32 children aged 1–14 years with chronic hepatitis B. The children received recombinant interferon alpha 2a 5 megaunits/m 2 three times weekly for 6 months. Complete response was seen in 31.2% of patients. Twenty-two children aged 4–14 years with chronic hepatitis B showing the similar characteristics were observed without treatment. Spontaneous seroconversion rate in this group was 4.5% ( p<0.05). The age and sex of the patient, the route of transmission and the duration of HBsAg positivity were not found to be important, whereas mean alanine aminotransferase levels of the responders were statistically higher than in the non-responders ( p<0.05). Early side effects, which include the flu-like symptom complex, were observed in all treated children but generally resolved within 2 weeks of therapy. Among the late side effects, autoimmune side effects manifested with the presence of antithyroid antibodies after the cessation of therapy was detected in one child. Two patients experienced seizure disorder during the therapy but have not required anticonvulsant therapy or discontinuation of interferon treatment. We conclude that interferon alpha 2a is an effective and tolerable form of therapy in children with chronic hepatitis B virus infection. Nevertheless, we recommend monitoring thyroid function before and after treatment as well as being cautious in using this form of treatment in children with coexistent seizure disorder.

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