title: Does genotype predict response to treatment in children infected with hepatitis B perinatally?
abstract: HBV genotype may correlate with outcome and treatment response. Genotype has been compared with treatment response in children infected perinatally with hepatitis B following treatment with oral antiviral drugs (lamivudine or adefovir) or interferon (IFN) alone and with prednisolone priming (Pred/IFN). All children who took part in clinical trials in this unit since 1990 were included. Hepatitis B genotypes were determined by direct sequencing or using a commercial line probe assay (InnoLipa). Sixty-five children were included; 20 were treated with IFN; 19 with Pred/IFN; 22 with lamivudine and 7 with adefovir, some took part in more than one treatment study. 63 out of 65 children were clearly typed into single genotypes; 16, 7, 3, and 37 typing as A, B, C, and D respectively. The majority of South-Asian children had genotype D and European and Afro-Caribbean children were more likely to have genotype A. Treatment response (seroconversion from HBeAg to Anti-HBe) was better in children with genotypes A [n = 16] and D [n = 37] (55.5% and 48.7%), compared to those with B [n = 7] and C [n = 3] (12.5% and 0%) for all treatments. The response to interferon alone was better in children with genotype A compared to D (50% and 36%), but prednisolone priming improved the response so that there was no difference between genotypes A and D (66.7% and 70%). Assessment of genotype in children pre-treatment may provide a guide to potential response. The response to treatment by genotype should be evaluated in future clinical trials in children.
authors.affiliation: Virology Laboratory, Health Protection Agency, Microbiology Services Division, Heartlands Hospital, Birmingham, United Kingdom. liz@boxall.info
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Boxall
authors.forename: Jaswant
authors.initials: J
authors.lastname: Sira
authors.forename: Shamima
authors.initials: S
authors.lastname: Kaskar
authors.forename: Judith
authors.initials: J
authors.lastname: Workman
authors.forename: Deirdre
authors.initials: D
authors.lastname: Kelly
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004279:DNA, Viral / Q000235:genetics; D005838:Genotype; D006509:Hepatitis B / Q000188:drug therapy* / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D019259:Lamivudine / Q000008:administration & dosage; D063065:Organophosphonates / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D007372:Interferons; D011239:Prednisolone; D000225:Adenine