title: Interferon-alpha treatment of children and young adults with chronic hepatitis delta virus (HDV) infection.
abstract: OBJECTIVE
  To determine the response of one-year interferon-alpha therapy in hepatitis delta virus (HDV) infection in children and young adults at a tertiary care hospital, Karachi, Pakistan.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Sarwar Zuberi Liver Centre (SZLC), Medical Unit IV, Civil Hospital, Karachi/Dow University of Health Sciences (DUHS), from June 2009 to July 2010.
  
  
  METHODS
  Paediatric patients (< 18 years age) and young adults (18-35 years) presenting were screened for hepatitis B virus (HBV) and HDV sero-markers. HDV anti-body positive by ELISA were further screened for hepatitis D ribonucleic acid (HDV-RNA) by real time PCR. HDV RNA PCR positive patients were treated with INF-a (children 6 MIU/m2/day and adults 5 MIU/day) for a period of one year. Patients were assessed monthly. Haematological parameters and ALT were monitored during treatment. Clinical progress (side effects) and negative HDV RNA were used as response criteria.
  
  
  RESULTS
  Overall 49 patients were HDV RNA positive (children: n=15, mean age 15±2.92 years adults: n=34, mean age 27±4 years). Eighty percent were male. Treatment was given to 25 patients (children: n=11, adults: n=14). HBV genotype D was the predominant in all HDV RNA positive patients (73%). Eighty percent (20/25) were HDV-RNA negative after one year of treatment, and remaining patients are still under treatment. Side effects were tolerated well and children continued regular activity. Haematological parameters were unremarkable. Children maintained their pre-treatment centile for height and weight (growth parameters). ALT levels were significantly decreased post-treatment.
  
  
  CONCLUSIONS
  Conventional INF-a was safe in children with HDV infection in terms of side effects and growth parameters. Eighty percent were HDV-RNA negative one year after treatment. Further follow-up 2 years post-treatment will give conclusive results.
authors.affiliation: Department of Paediatrics, Dow University of Health Sciences, Karachi. sigma_98@hotmail.com
authors.forename: Sina
authors.initials: S
authors.lastname: Aziz
authors.forename: Jamila
authors.initials: J
authors.lastname: Rajper
authors.forename: Wajeeha
authors.initials: W
authors.lastname: Noor-ul-Ain
authors.forename: Aisha
authors.initials: A
authors.lastname: Mehnaz
authors.forename: Muhammad
authors.initials: M
authors.lastname: Masroor
authors.forename: Mei Hwei
authors.initials: MH
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019701:Hepatitis D, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D003698:Hepatitis Delta Virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D010154:Pakistan; D016133:Polymerase Chain Reaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D016898:Interferon-alpha