Does interferon and ribavirin combination therapy increase the rate of treatment response in children with hepatitis C?
BACKGROUND
Interferon-alpha was the first accepted treatment of chronic hepatitis C. In recent years, adding ribavirin has produced better response rates in adult patients than monotherapy with interferon-alpha. Whether adding ribavirin also improves treatment results in pediatric patients remains unclear.


METHODS
Twelve patients were given 3 million U/m 2 subcutaneous interferon-alpha three times weekly and 15 mg/kg oral ribavirin daily, and 10 patients were given only 3 million U/m 2 subcutaneous interferon-alpha three times weekly for a total of 12 months.


RESULTS
The dropout rate was 22.8% (25% for patients receiving combination treatment versus 20% for those receiving monotherapy). At the end of treatment, viral clearance was achieved in 50% of the patients who received combination treatment versus 30% of those who received monotherapy. After 12 months of posttreatment follow-up, sustained response rates were 30% and 41.7%, respectively. Of those who responded to treatment, 66.7% had received ribavirin whereas 37.5% of nonresponders had received ribavirin therapy.


CONCLUSIONS
Adding ribavirin to interferon treatment improved end-of-treatment response rates in children with chronic hepatitis C. Tolerance of treatment was similar to tolerance of monotherapy. However, studies of greater numbers of pediatric patients with longer follow-up periods are necessary to determine prolonged sustained response.
Süoğlu  D
Ozlem D
OD
Pediatric Gastroenterology and Hepatology Department, Istanbul School of Medicine, Istanbul University, Turkey. odsuoglu@istanbul.edu.tr
Elkabes
Berna
B
Sökücü
Semra
S
Saner
Günay
G
D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D006801:Humans; D007223:Infant; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D065227:Transfusion Reaction; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin