Long-term therapeutic efficacy of lamivudine compared with interferon-alpha in children with chronic hepatitis B: the younger the better.
OBJECTIVE
To assess and compare the long-term therapeutic response to lamivudine compared with interferon-alpha (IFN-alpha) in children with chronic hepatitis B.


METHODS
A total of 40 children (27 male; age, 1.3-18 y, mean, 7.7 y) with chronic hepatitis B who received lamivudine for at least 12 months were followed for a mean period of 39 (24-76) months. Their treatment efficacy was historically compared with that of 19 children (14 male; age, 2.1-17 y; mean, 10 y) who had been treated with IFN-alpha and were followed for a mean period of 39 (24-104) months. Therapeutic responses were compared at 2 y after the initiation of either of the treatment methods.


RESULTS
Two years after the initiation of treatment, the results for children treated with lamivudine versus IFN-alpha were as follows: hepatitis B e antigen (HBeAg) seroconversion occurred in 26 (65%) of the 40 children versus 7 (37%) of the 19 children, P < 0.05. In the lamivudine-treated group, the results for children treated before the age of 7 versus age >7 were as follows: HBeAg seroconversion occurred in 17 (89%) of the 19 children versus 9 (43%) of the 21 children, P < 0.01, and loss of hepatitis B surface antigen (HBsAg) occurred in 8 (42%) versus 0%, P < 0.001.


CONCLUSIONS
Long-term treatment of lamivudine led to significant improvement in the seroconversion rate of HBeAg in children with chronic hepatitis B compared with IFN-alpha therapy. Furthermore, in preschool-age children, it led to significant improvement in the seroconversion rate of HBeAg and HBsAg compared with school-age children.
Choe
Byung-Ho
BH
Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea. bhchoi@mail.knu.ac.kr
Lee
Ji Hye
JH
Jang
You Cheol
YC
Jang
Chang Hwan
CH
Oh
Ki Won
KW
Kwon
Soonhak
S
Hyun
Myung Chul
MC
Ko
Cheol Woo
CW
Lee
Kun Soo
KS
Lee
Won Kee
WK
D000293:Adolescent; D000367:Age Factors; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D016898:Interferon-alpha / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha; D019259:Lamivudine