Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
Clin Infect Dis. 2013 Apr;56(7):961-7. doi: 10.1093/cid/cis1031. Epub 2012 Dec 12.
A systematic review and meta-analysis were conducted to examine the efficacy and safety of pegylated interferon (peg-IFN) alfa-2a and peg-IFN alfa-2b plus ribavirin (RBV) in children and adolescents with chronic hepatitis C virus (HCV).
Medline, Embase, and Cochrane Central Register of Controlled Trials were searched. Clinical trials examining peg-IFN alfa-2a or peg-IFN alfa-2b plus RBV among persons ages 3-18 years with HCV were included. Data were abstracted for complete early virologic response (EVR), sustained virologic response (SVR), relapse, treatment discontinuations, hematologic and dermatologic adverse events, and growth inhibition.
Eight trials met the inclusion criteria. Results indicate that 70% of subjects (95% confidence interval [CI], 58%-81%) achieved EVR, and 58% (95% CI, 53%-64%) achieved SVR. EVR and SVR were higher for those with HCV genotypes 2/3 than 1/4. Discontinuation due to adverse events and discontinuation due to viral breakthrough were each 4%, discontinuation due to a lack of response was 15%, and relapse was 7%. Anemia, neutropenia, leukopenia, and thrombcytopenia were 11%, 32%, 52%, and 5%, respectively. Alopecia, injection site erythema, and pruritus were 13%, 27%, and 10%, respectively. Small growth inhibitions were observed during treatment.
The results of this meta-analysis indicate that peg-IFN/RBV combination treatment is effective and safe in treating children and adolescents with HCV.
系统评价和荟萃分析旨在检查聚乙二醇干扰素（peg-IFN）alfa-2a 和 peg-IFN alfa-2b 加利巴韦林（RBV）在儿童和青少年慢性丙型肝炎病毒（HCV）中的疗效和安全性。
检索了 Medline、Embase 和 Cochrane 对照试验中心注册库。纳入了年龄在 3-18 岁的 HCV 患者接受 peg-IFN alfa-2a 或 peg-IFN alfa-2b 加 RBV 治疗的临床试验。提取完全早期病毒学应答（EVR）、持续病毒学应答（SVR）、复发、治疗中断、血液学和皮肤病学不良事件以及生长抑制的数据。
八项试验符合纳入标准。结果表明，70%的患者（95%置信区间 [CI]，58%-81%）达到 EVR，58%（95% CI，53%-64%）达到 SVR。基因型 2/3 的患者 EVR 和 SVR 更高。因不良事件和病毒突破而停药的比例分别为 4%，因无应答而停药的比例为 15%，复发的比例为 7%。贫血、中性粒细胞减少、白细胞减少和血小板减少分别为 11%、32%、52%和 5%。脱发、注射部位红斑和瘙痒分别为 13%、27%和 10%。治疗期间观察到轻微的生长抑制。
这项荟萃分析的结果表明，peg-IFN/RBV 联合治疗在治疗儿童和青少年 HCV 方面是有效和安全的。
