Treatment of chronic viral hepatitis C in children and adolescents: UK experience.
OBJECTIVE
To review the efficacy and tolerability of pegylated interferon-α and ribavirin for treatment of chronic hepatitis C (CHC) in children in the UK.


METHODS
Retrospective review of children treated for CHC in 3 UK paediatric specialist liver centres between 2005 and 2010. Data on viral response to treatment, demographic and clinical details were collected. Treatment outcome was assessed by the absence of detectable viral RNA in blood 24 weeks after treatment-sustained viral response (SVR).


RESULTS
75 children were included; 34 genotype 1; 39 genotypes 2 and 3; 2 genotype 4. Overall SVR was achieved in 54/71 (76%); 65% genotype 1; 89% genotypes 2 and 3; 100% genotype 4. Early response at 12 weeks was achieved in 53 and sustained in 47 (89%). Data on rapid response after 4 weeks of treatment were available in 25; 17/25 (68%) responded and 16 of these (94%) achieved SVR. IL28 T/T genotype was associated with higher SVR. There were no significant changes in weight and height z scores from baseline compared with 24 weeks post-treatment follow-up. No child discontinued treatment due to side effects, although 43 required dose modification. Treatment affected quality of life (QoL) in the initial 12 weeks of treatment, which improved by the end of treatment.


CONCLUSIONS
Children respond well to therapy for CHC. Treatment was tolerated with minimal impact on QoL and no significant effect on growth. Knowledge of viral and IL28 genotypes and early viral response is useful to plan treatment in children and provide appropriate counselling.
Liver Unit, Birmingham Children's Hospital, Birmingham, UK.
M
M
Abdel-Hady
Children's Liver Centre, King's College Hospital, London, UK.
S
S
Bansal
Liver Unit, Leeds Teaching Hospitals, Leeds, UK.
S M
SM
Davison
Liver Unit, Birmingham Children's Hospital, Birmingham, UK.
M
M
Brown
Children's Liver Centre, King's College Hospital, London, UK.
S A
SA
Tizzard
Liver Unit, Leeds Teaching Hospitals, Leeds, UK.
S
S
Mulla
Peter Medawar Building for Pathogen Research and Oxford NIHR BRC, Oxford University, Oxford, UK.
E
E
Barnes
Institute of Child's Health, Birmingham Children's Hospital, Birmingham, UK.
P
P
Davies
Children's Liver Centre, King's College Hospital, London, UK.
G
G
Mieli-Vergani
Liver Unit, Birmingham Children's Hospital, Birmingham, UK.
D A
DA
Kelly
D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006526:Hepatitis C / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D011788:Quality of Life; D012367:RNA, Viral / Q000235:genetics; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D006113:United Kingdom
D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
Hepatology; Infectious Diseases