Long‐term Therapeutic Efficacy of Lamivudine Compared With Interferon‐α in Children with Chronic Hepatitis B: The Younger the Better

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 44; no. 1; pp. 92 - 98
• Main Authors: Choe, Byung‐Ho, Lee, Ji Hye, Jang, You Cheol, Jang, Chang Hwan, Oh, Ki Won, Kwon, Soonhak, Hyun, Myung Chul, Ko, Cheol Woo, Lee, Kun Soo, Lee, Won Kee
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-01-2007; Lippincott
• Subjects: Adolescent; Age Factors; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Children; Chronic hepatitis B; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Hepatitis B, Chronic - drug therapy; Human viral diseases; Humans; Infant; Infectious diseases; Interferon; Interferon-alpha - therapeutic use; Lamivudine; Lamivudine - therapeutic use; Male; Medical sciences; Pharmacology. Drug treatments; Treatment; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Viral diseases; Viral hepatitis; Antiretroviral agent; RNA-directed DNA polymerase; Hepatic disease; Chronic hepatitis B-Children- Interferon-Lamivudine-Treatment; Viral hepatitis B; Reverse transcriptase inhibitor; Gastroenterology; Nucleoside analog; Antiviral; Pyrimidine nucleoside; Child; Viral hepatitis E; Human; Enzyme; Transferases; Cytokine; Enzyme inhibitor; Lamivudine; Metabolic diseases; Long term; Infection; Nucleotidyltransferases; Treatment; Dideoxynucleoside; Viral disease; Digestive diseases; Interferon
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/01.mpg.0000243439.47334.4e

ABSTRACT
Objectives:
To assess and compare the long‐term therapeutic response to lamivudine compared with interferon‐α (IFN‐α) in children with chronic hepatitis B.
Methods:
A total of 40 children (27 male; age, 1.3–18 y, mean, 7.7 y) with chronic hepatitis B who received lamivudine for at least 12 months were followed for a mean period of 39 (24–76) months. Their treatment efficacy was historically compared with that of 19 children (14 male; age, 2.1–17 y; mean, 10 y) who had been treated with IFN‐α and were followed for a mean period of 39 (24–104) months. Therapeutic responses were compared at 2 y after the initiation of either of the treatment methods.
Results:
Two years after the initiation of treatment, the results for children treated with lamivudine versus IFN‐α were as follows: hepatitis B e antigen (HBeAg) seroconversion occurred in 26 (65%) of the 40 children versus 7 (37%) of the 19 children, P < 0.05. In the lamivudine‐treated group, the results for children treated before the age of 7 versus age >7 were as follows: HBeAg seroconversion occurred in 17 (89%) of the 19 children versus 9 (43%) of the 21 children, P < 0.01, and loss of hepatitis B surface antigen (HBsAg) occurred in 8 (42%) versus 0%, P < 0.001.
Conclusions:
Long‐term treatment of lamivudine led to significant improvement in the seroconversion rate of HBeAg in children with chronic hepatitis B compared with IFN‐α therapy. Furthermore, in preschool‐age children, it led to significant improvement in the seroconversion rate of HBeAg and HBsAg compared with school‐age children.