[Treatment of chronic hepatitis with interferon in children with kidney diseases].
The study aimed at evaluation of chronic hepatitis treatment results in children previously treated from nephrological indications in 1994-2002 years.


METHODS
Examination was performed in 42 children in the age 10.2 +/- 4.8 years at the onset time of interferon (INF) treatment application. In 30 children (71.4%) chronic HBV infection, in 8 (19.1%) - HCV infection, in 4 (9.5%) - mixed HBV and HCV infection in phase of replication was revealed. Among examined children in 26 (61.9%) symptoms of glomerulonephritis were previously reported, in 17 (40.5%) - symptoms of nephrotic syndrome; in 9 (21.4%) - chronic renal failure was observed. 22 children received prednisone treatment. Concentrations of albumin, gamma- globulin, bilirubin, haemoglobin, creatinine, haematocrit, leukocytosis, activity of alanine aminotransferase (ALT), chronic hepatitis markers, before, during and 6 and 12 months after treatment termination were evaluated. IFN alpha-2a, alpha-2b and human recombined IFN-alpha were applied


RESULTS
In 22 (52.4%) children ALT values before treatment not exceeded 100 IU/l. Liver biopsy was performed in 39 children. In 18 (46.2%) - high activity of inflammatory process was revealed; only in 5 of them with ALT activity above 100 IU/l. Higher leukocytosis at the beginning of treatment was accompanied by diminished activity of inflammatory process. In 14/34 children seroconversion was obtained in HBe markers, in 4/12 HCV-RNA elimination occurred after the 1st course of IFN. Only in 5 (11.9%) children treatment was stopped because of side effects (not connected with urinary tract), in 1 - because of relapse of main disease. 2nd course was applied in 13 children. In 2 - seroconversion in HBe markers was obtained.


CONCLUSIONS
Considering the small number of examined children full evaluation of chronic hepatitis treatment efficacy is not possible. It seems comparable as observed in population of children without the risk of nephropathies. IFN treatment in children on previous medication of kidney disease, in most cases does not create complications leading to earlier drug cessation. In the case of glomerulonephritis also does not bear an increased risk of relapse of main disease.
Szczepańska
Maria
M
Klinika Pediatrii, Nefrologii i Endokrynologii Dzieciecej Slaskiej Akademii Medycznej w Zabrzu.
Tobis
Anna
A
Schneiberg
Barbara
B
Szprynger
Krystyna
K
Kobos
Edyta
E
Morawiec-Knysak
Aurelia
A
D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D007372:Interferons