Vo Thi Diem Hanh, Bourgois Annick, Bontems Patrick, Goyens Philippe, Buts Jean Paul, Nackers Fabienne, Tonglet René, Sokal Etienne Marc
Université Catholique de Louvain, Cliniques Saint-Luc, Département de Pédiatrie, Brussels, Belgium.
J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):141-5. doi: 10.1097/00005176-200502000-00011.
To investigate the virological outcome of chronic hepatitis B (CH-B) in children who received interferon alpha (IFN) compared with no treatment.
Seventy-four children with CH-B (median age, 6.1 years; 44 boys) selected from a cohort of 158 cases were included and divided into two groups: IFN-treated (n = 37) and control (n = 37). The controls were matched with the treated children by baseline alanine aminotransferase (ALT) levels, sex and age. The Kaplan-Meier method was performed to estimate the time to clearance of hepatitis B e antigen (HbeAg) and hepatitis B surface antigen (HbsAg).
Mean duration of follow-up was comparable in two groups (5.2 +/- 3.8 years in treatment group versus 5.2 +/- 3.7 years in control group, NS). HBeAg and HBsAg loss occurred in 20 (54.1%) and three treated children versus 13 (35.1%) and one untreated children (NS), respectively. The 7-year cumulative HBeAg and HBsAg clearance rates were 47.5% and 8.9% after the first visit in the treatment group versus 33.5% and 4.0% in untreated children (NS), respectively. Elevated baseline ALT (two times upper limit of normal) had a significant effect on the long-term cumulative rate of HBeAg seroconversion in treated patients (P = 0.01) but not in the untreated group.
These findings show that the overall long-term virological outcome does not differ significantly between IFN-treated and untreated children but that a significant benefit of treatment on the long term rate of HBeAg seroconversion is obtained in children with higher baseline ALT levels.
研究接受α干扰素（IFN）治疗的儿童慢性乙型肝炎（CH - B）与未治疗儿童相比的病毒学转归情况。
从158例队列中选取74例CH - B儿童（中位年龄6.1岁；44例男孩），分为两组：IFN治疗组（n = 37）和对照组（n = 37）。对照组与治疗组儿童在基线丙氨酸氨基转移酶（ALT）水平、性别和年龄方面相匹配。采用Kaplan - Meier法估计乙肝e抗原（HbeAg）和乙肝表面抗原（HbsAg）清除时间。
两组的平均随访时间相当（治疗组为5.2±3.8年，对照组为5.2±3.7年，无统计学差异）。治疗组20例（54.1%）和3例儿童出现HBeAg和HBsAg消失，而未治疗组分别为13例（35.1%）和1例儿童（无统计学差异）。治疗组首次就诊后7年的HBeAg和HBsAg累积清除率分别为47.5%和8.9%，未治疗儿童分别为33.5%和4.0%（无统计学差异）。基线ALT升高（高于正常上限两倍）对治疗患者的HBeAg血清学转换长期累积率有显著影响（P = 0.01），但对未治疗组无影响。
这些研究结果表明，IFN治疗组和未治疗组儿童的总体长期病毒学转归无显著差异，但基线ALT水平较高的儿童在HBeAg血清学转换长期率方面可从治疗中获得显著益处。
