Interferon-alpha treatment of chronic hepatitis B in childhood: a consensus advice based on experience in European children.
BACKGROUND
The efficacy of interferon (IFN) in children with chronic hepatitis B has been evaluated in randomized controlled trials over the past decade, but recommendations for treatment based on this experience have not been published yet. The purpose of this workshop, held in Madrid in October 1997, was to provide pediatricians with guidelines for practical use of IFN in hepatitis B.


METHODS
Eighteen European pediatricians and hepatologists agreed to report and discuss their experience on 1,122 treated children, 40% of whom were considered responders.


RESULTS
Agreement was obtained on the following main items: 1) rationale for treatment is to accelerate hepatitis B early antigen (HBeAg) clearance in a subgroup of patients; 2) candidates for treatment are children with HBeAg and HBV DNA positivity, with low-intermediate HBV DNA levels and abnormal alanine aminotransferase values, aged 2 years or more; 3) IFN is contraindicated in children with decompensated liver disease, cytopenia, severe renal or cardiac disorders, and autoimmune disease; 4) the standard treatment regimen is 5 mU/m2 thrice weekly for 6 months. Retreatment in nonresponders is not indicated.


CONCLUSIONS
A consensus was obtained on the use of IFN in children with hepatitis B, based on its short-term efficacy. The long-term clinical and virological effects of the drug, however, remain to be evaluated.
Jara
P
P
Hepatology Unit, Hospital Infantil La Paz, Madrid, Spain.
Bortolotti
F
F
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D018849:Controlled Clinical Trials as Topic; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D005060:Europe; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha