Clinical

Peginterferon-ribavirin safe, effective for children with HCV

Last Updated: 2008-03-06 13:56:54 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treatment with pegylated interferon alfa-2b (PEG-IFN-alpha-2b) plus ribavirin results in virologic control in children with chronic hepatitis C virus (HCV) infection and is "reasonably well-tolerated," a Spanish team reports in the February issue of The Pediatric Infectious Disease Journal.

Investigators at Children's University Hospital "La Paz" in Madrid, Spain, studied 30 children between 3 and 16 years of age with detectable hepatitis C virus (HCV) RNA, elevated alanine aminotransferase values and disease duration of more than 3 years.

Children received PEG-IFN-alpha-2b, 1.0 mcg/kg weekly, plus ribavirin, 15 mg/kg daily. Children with HCV genotype 2/3 received 24 weeks of treatment. Those with genotype 1/4 received 48 weeks of combination therapy.

Sustained virologic response occurred in 50% of children, Dr. Paloma Jara and colleagues report. After 12 weeks of treatment, 52% of patients were HCV RNA negative and 72% had a more than 2 log10 decrease in viral load over baseline.

Treatment had to be discontinued in three patients because of adverse events. Severe neutropenia that required a reduction in dose of PEG-IFN-alpha-2b occurred in 23% of patients. No patient required a reduction in dose of ribavirin.

The investigators conclude that the combination of ribavirin and PEG-IFN-alpha-2b is effective for children with chronic HCV infection and results in a sustained viral response in the majority of patients treated. Viral response at 12 weeks is a predictor of future response.

The combination is "reasonably well tolerated, with no unexpected or permanent adverse effects" the investigators note. The rate of adverse effects was similar to that of INF-alpha alone.

Studies are now needed to determine the optimum combination treatment regimen for children with chronic HCV infection, Dr. Jara's team concludes.

Pediatr Infect Dis J 2008;27:142-148.