Treatment of chronic viral hepatitis C in children and adolescents: UK experience
Treatment of chronic viral hepatitis C in children and adolescents: UK experience
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DOI：
10.1136/archdischild-2013-304601
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发表时间：
2014-06-01
影响因子：
5.2
通讯作者：
Kelly, D. A.
中科院分区：
文献类型：
--
作者：
Abdel-Hady, M.;Bansal, S.;Kelly, D. A.
目的 回顾聚乙二醇干扰素-a 和利巴韦林治疗英国儿童慢性丙型肝炎 (CHC) 的疗效和耐受性。方法对 2005 年至 2010 年间在英国 3 个儿科专科肝脏中心接受 CHC 治疗的儿童进行回顾性回顾。收集病毒对治疗反应、人口统计学和临床详细信息的数据。治疗结果通过治疗持续病毒反应 (SVR) 后 24 周血液中检测不到病毒 RNA 的情况来评估。结果 纳入了 75 名儿童； 34基因型1； 39 基因型 2 和 3； 2 基因型 4。总体 SVR 达到 54/71 (76%)； 65% 基因型 1； 89% 基因型 2 和 3； 100% 基因型 4。53 例患者在 12 周时获得早期缓解，47 例患者（89%）持续缓解。 25 人获得了治疗 4 周后快速反应的数据； 17/25 (68%) 做出了回应，其中 16 人 (94%) 实现了 SVR。 IL28 T/T 基因型与较高的 SVR 相关。与治疗后 24 周随访相比，体重和身高 z 评分与基线相比没有显着变化。尽管有 43 名儿童需要调整剂量，但没有儿童因副作用而停止治疗。治疗影响了治疗最初 12 周的生活质量 (QoL)，并在治疗结束时有所改善。 结论 儿童对 CHC 治疗反应良好。治疗是耐受的，对生活质量的影响很小，对生长没有显着影响。了解病毒和 IL28 基因型以及早期病毒反应有助于规划儿童治疗并提供适当的咨询。
Aim To review the efficacy and tolerability of pegylated interferon-a 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.