title: Pegylated interferon for chronic hepatitis C in children affects growth and body composition: results from the pediatric study of hepatitis C (PEDS-C) trial.
abstract: Weight loss and changes in growth are noted in children treated with interferon alpha (IFN-α). The aim of this study was to prospectively determine changes in weight, height, body mass index (BMI), and body composition during and after treatment of children with hepatitis C virus (HCV). Children treated with pegylated interferon alpha-2a (Peg-IFN-α2a) ± ribavirin in the Pediatric Study of Hepatitis C (PEDS-C) trial underwent anthropometric measurements, dual-energy X-ray absorptiometry scan, as well as dietary and activity assessments during and after treatment. One hundred and fourteen (55% male) children, with a mean age of 11 ± 3 years, were randomized, and 107 received treatment for at least 24 weeks. Subjects were divided into three groups according to duration of treatment: 24 (N = 14), 48 (N = 82), or 72 (N = 11) weeks. Decrements of up to 0.50 z score were observed for weight, height, and BMI while on therapy among all groups (P ≤ 0.01, compared to baseline). In the group treated for 48 weeks, 29 (33%) subjects had greater than 0.5-unit decrement in height-for-age z (HAZ) score. Though weight-for-age and BMI z scores returned to baseline after cessation of therapy, mean HAZ score was slower to rebound, still lower than baseline at 96 weeks post-therapy for the long-treatment duration group (P = 0.03) and lower than baseline in most children treated for 48 weeks. Percent body fat, fat-free mass z scores, and triceps skinfold z scores decreased with therapy. Dietary energy intake and levels of physical activity did not change during treatment.
  
  
  CONCLUSIONS
  Peg-IFN-α2a was associated with significant changes in body weight, linear growth, BMI, and body composition in children. These effects were generally reversible with cessation of therapy, although HAZ scores had not returned to baseline after 2 years of observation in many. Longer term growth data are needed among children treated for chronic HCV.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. maureen.jonas@childrens.harvard.edu
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Jonas
authors.forename: William
authors.initials: W
authors.lastname: Balistreri
authors.forename: Regino P
authors.initials: RP
authors.lastname: Gonzalez-Peralta
authors.forename: Barbara
authors.initials: B
authors.lastname: Haber
authors.forename: Steven
authors.initials: S
authors.lastname: Lobritto
authors.forename: Parvathi
authors.initials: P
authors.lastname: Mohan
authors.forename: Jean P
authors.initials: JP
authors.lastname: Molleston
authors.forename: Karen F
authors.initials: KF
authors.lastname: Murray
authors.forename: Michael R
authors.initials: MR
authors.lastname: Narkewicz
authors.forename: Philip
authors.initials: P
authors.lastname: Rosenthal
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Schwarz
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Barton
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
authors.forename: Paul D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects; D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004435:Eating / Q000187:drug effects; D005234:Fatty Liver / Q000821:virology; D005260:Female; D006130:Growth Disorders / Q000139:chemically induced*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000821:virology; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a