Factors predictive of response to interferon therapy in children with chronic hepatitis B.
OBJECTIVE
The efficacy of interferon therapy in Caucasian children with chronic hepatitis B is similar to that in adults. However, little information is available about factors predicting response to this therapy in children. We have performed a univariate analysis to assess the strength of association between basal variables and response, and a multivariate analysis to determine the combination of basal variables which give the best prediction of response in terms of sensitivity and specificity.


METHODS
The basal parameters were studied in 50 children included in three different trials of interferon alpha therapy (360-700 MU/square meter of body surface, 2 or 3 times weekly for 12 to 24 weeks).


RESULTS
Of these, 18 (36%) were responders. In the univariate analysis, a higher histological activity (p < 0.05), a lower percentage of HBcAg-stained hepatocytes (p < 0.001), aspartate amino transferase and alanine aminotransferase levels (p < 0.05) and alanine aminotransferase peak prior to serum HBV-DNA clearance (p < 0.05), were associated to the response. In the multivariate analysis, the combinations of the percentage of HBcAg stained cells with alanine aminotransferase levels and with the histological activity index were the best variables for predicting response (sensitivity: 100% and specificity: 89% and 86%, respectively).


CONCLUSIONS
Factors predictive of response in children with chronic hepatitis B are similar to those found in adults, and may help in identifying those children with a better chance of responding.
Ruiz-Moreno
M
M
Department of Pediatrics, Fundación Jiménez Diaz, Madrid, Spain.
Camps
T
T
Jimenez
J
J
López
R
R
Castillo
I
I
Bartolomé
J
J
Carreño
V
V
D002648:Child; D002908:Chronic Disease; D005260:Female; D006509:Hepatitis B / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D016898:Interferon-alpha