title: Side effects of alpha-interferon therapy and impact on health-related quality of life in children with chronic viral hepatitis.
abstract: BACKGROUND
  Interferon (IFN) is standard therapy for chronic viral hepatitis in children. The aim of this study was to evaluate the side effects of alpha-interferon (IFN) in 94 consecutive children (58 males; age range, 3 to 14 years) affected by chronic viral hepatitis treated with different schedules ranging from 3 to 10 MU and from 3 to 12 months, and the impact of this therapy on health-related quality of life.
  
  
  METHODS
  Side effects were evaluated with clinical and laboratory examinations and were recorded on a diary card. The health-related quality of life was evaluated with a modified version of the Sickness Impact Profile.
  
  
  RESULTS
  All patients experienced at least one adverse reaction to IFN treatment; 80% had more than five side effects. There were no life-threatening reactions. Three children experienced severe reactions (febrile seizure, severe hypertransaminasemia and relapsing episodes of epistaxis, respectively) that required permanent IFN withdrawal. Another child had a febrile seizure requiring temporary IFN withdrawal. In seven children the neutrophil count fell below 1000/mm3 and promptly increased when IFN was temporarily discontinued. The remaining children had mild or moderate clinical and/or laboratory adverse reactions. Age, sex, viral etiology of chronic hepatitis and response to therapy were not significantly associated with the appearance of side effects. The pre-IFN health-related quality of life was good in all children; it deteriorated significantly during IFN therapy and returned to basal standards within 3 months after IFN withdrawal. No patient required suspension of IFN therapy because of worsening of health-related quality of life.
  
  
  CONCLUSIONS
  Children have a low risk of developing severe IFN-induced side effects. Adverse reactions and worsening of health-related quality of life were tolerable and did not seem to be a limiting factor for IFN therapy in young candidates.
authors.affiliation: Department of Pediatrics, University of Naples Federico II, Italy. vegnente@unina.it
authors.forename: R
authors.initials: R
authors.lastname: Iorio
authors.forename: P
authors.initials: P
authors.lastname: Pensati
authors.forename: S
authors.initials: S
authors.lastname: Botta
authors.forename: S
authors.initials: S
authors.lastname: Moschella
authors.forename: N
authors.initials: N
authors.lastname: Impagliazzo
authors.forename: P
authors.initials: P
authors.lastname: Vajro
authors.forename: A
authors.initials: A
authors.lastname: Vegnente
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D011788:Quality of Life; D018434:Sickness Impact Profile
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha