Serum fibrosis markers as predictors of an antifibrotic effect of interferon alfa in children with chronic hepatitis B.
OBJECTIVE
Interferon alfa (IFN-alpha) may retard hepatic fibrogenesis in adults with chronic hepatitis C. We evaluated prospectively four selected serum fibrosis markers before, immediately after and 12 months after IFN treatment of children with chronic hepatitis B (CHB).


METHODS
Forty-seven children (mean age 8 years, range 4-16) with CHB underwent IFN-alpha treatment (3 MU t.i.w.) for 5 months. Fibrosis and inflammation were assessed blindly before and 12 months after the end of treatment. Serum laminin-2, collagen IV, MMP-2 and MMP-9/TIMP-1 complex were determined using automated assays.


RESULTS
Twelve months after treatment had been discontinued levels of laminin-2, collagen IV and MMP-2 were decreased, and serum MMP-9/TIMP-1 complex was increased. Levels did not differ between sustained responders (42.5%) and non-responders. Similarly, fibrosis did not progress in both groups, whereas histological inflammation improved only in responders.


CONCLUSIONS
A 5 month IFN-alpha treatment has no marked effect on histological liver fibrosis in children with CHB, irrespective of virological response. The evolution of serum fibrosis markers suggests they may be more sensitive to detect minor antifibrotic effects than semiquantitative follow-up histology.
IIIrd Dept of Pediatrics, Medical University, Bialystok, Poland.
Dariusz M
DM
Lebensztejn
Maria E
ME
Sobaniec-Łotowska
Michael
M
Bauer
Maciej
M
Kaczmarski
Michael
M
Voelker
Detlef
D
Schuppan
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D024141:Collagen Type IV / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D011446:Prospective Studies; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
D015415:Biomarkers; D024141:Collagen Type IV; D016898:Interferon-alpha; D019715:Tissue Inhibitor of Metalloproteinase-1; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9