TREATMENT OF CHRONIC C HEPATITIS IN
CHILDREN & ADOLESCENTS
Georgieva-Shakola M, Tzaneva V, Sheitanova M*
Clinic of Pediatric Endocrinol & Gastroenterol, Clinic of
Pediatric Haematol*, University Hospital ¡°St. Marina¡±, Varna, Bulgaria
Objective: In Bulgaria hepatitis C
(HC) is relatively rare cause of chronic liver disease in childhood ¨C
transfused pts. (hemophilic) or intravenous drug abusers. Study¡¯s aim was
to evaluate the efficacy of treatment: 1/ with recombinant interferon alfa
2b (INF) for 6 months or 2/
INF+ Ribavirin (R) for 12 months in children with HC
Methods: In 1998-2000 8 children
(all boys) with a mean age of 12,9 with HC were treated with INF: 2 pts.
with INF 6 MU/m2 daily for 2 weeks, then this dose 3 times a week,
subcutaneously for 6 months & 5 pts. with INF (the same scheme)+ R
(12mg/kg/24h) for 12 months. HC was diagnosed by clinical, laboratory,
serological test, HCVRNA (+) tests & histological findings of chronic persistent
hepatitis. At 1 week intervals
during the treatment, each pts. was teasted for hemoglobin, leucocytes,
granulocytes, platelet cells, at 2 weeks intervals ¨C for aminotransferases.
There were clinical and laboratory controls after 6 months of treatment
& after the end of the treatment.
Results: The pts. treated with INF
had only biochemical response. The 4/5 pts. were treated with INF+R had
biochemical & virologic response. A transient influenza-like syndrome
was observed in all treated pts. during the first 1-2 weeks. Temporary
dosage changes were necessairy in 2 pts. for uncomplicated neutropenia.
Moderate leukopenia was observed in all pts. One pts. had an episode of
febrile convulsion.
Conclusion: The treatment with INF
alfa of HCV in children leaded to partial response. Complete response was
observed more often in cases treated with INF alfa + R. INF alfa & R
were generally well tolerated in children & adolescents.