Treatment of hepatitis B virus-associated nephropathy in black children.
The efficacy of interferon (IFN) in the treatment of hepatitis B virus (HBV)-associated nephropathy in black children has not been established. Twenty-four black children with biopsy-proven HBV-associated nephropathy were recruited into the study during the period April 1997 to June 1999. Five defaulted treatment and were excluded from the primary analysis. IFNalpha 2b was administered for 16 weeks. Response to treatment was defined as loss of HBeAg, decrease in proteinuria, and prevention of deterioration in renal and liver function. A control group of 20 patients was followed up for the same period. Ten (52.6%) of the treated children responded with clearance of HBeAg by 40 weeks. None cleared HBsAg. All responders showed remission of proteinuria, 90% maintained normal renal function and 1 (10%) showed improvement of renal function. HBV DNA levels decreased in this group. Nine patients did not clear HBeAg; none showed remission of proteinuria, and two showed deterioration of renal function. Liver enzymes rose during treatment but subsequently declined irrespective of response to therapy. No serious side effects were encountered. Only 5% of controls showed spontaneous clearance of HBeAg, and none had remission of proteinuria. Black children with HBV-associated nephropathy show accelerated clearance of HBeAg with remission of proteinuria following treatment with IFNalpha 2b. IFNalpha 2b was well tolerated.
Bhimma
Rajendra
R
Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of Natal, Private Bag 7, Congella 4013, South Africa. bhimma@nu.ac.za
Coovadia
Hoosen Mohamed
HM
Kramvis
Anna
A
Adhikari
Mirriam
M
Kew
Michael Charles
MC
D000293:Adolescent; D000410:Alanine Transaminase / Q000378:metabolism; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044383:Black People; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007674:Kidney Diseases / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology / Q000821:virology*; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000378:metabolism
D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase