Di Marco V, Giacchino R, Timitilli A, Bortolotti F, Crivellaro C, Calzia R, Iannuzzi C, Prestileo T, Vajro P, Nebbia G, Stringhi C, Rosina F, Biassoni D, Callea F, Rizzetto M, Craxi A
Istituto di Medicina Generale, University of Palermo, Italy.
J Viral Hepat. 1996 May;3(3):123-8. doi: 10.1111/j.1365-2893.1996.tb00002.x.
We assessed the efficacy of prolonged interferon-alpha (IFN) therapy in children with chronic hepatitis caused by hepatitis delta virus (HDV) by treating 26 paediatric cases with IFN-alpha 2b (5 MU m-2, then 3 MU m-2 three times weekly for 12 (medium-term group MTG) or 24 months (long-term group, LTG). Compliance and tolerability were acceptable. At the end of therapy a complete biochemical response [normalization of alanine aminotransferase (ALT)] occurred in 12 children (5/13 in MTG and 7/13 in LTG). A relapse occurred after stopping IFN in 10 cases (five in MTG and five in LTG). Two patients from the LTG had normal liver function tests during 12 months of follow-up. Six of the eight hepatitis B e antigen (HBeAg) positive children lost HBeAg, while all six hepatitis B virus (HBV) DNA positive patients lost HBV DNA during treatment. HBeAg reappeared later in two children. HDV RNA, present in 10/10 cases of MTG before treatment, persisted after 12 months IFN therapy in 3/10. One year after stopping therapy, 8/10 patients were again HDV RNA positive. Two children cleared hepatitis delta antigen (HDVAg) from the liver. No significant improvements in liver histology were seen in both groups. Our experience suggests that IFN-alpha treatment in children with chronic type D hepatitis has a transient effect, and long-term treatment does not appear to induce a greater therapeutic benefit in terms of biochemical and virological response.
我们通过对26例儿童患者使用α-2b干扰素（5 MU/m²，之后每周三次，每次3 MU/m²，持续12个月（中期治疗组，MTG）或24个月（长期治疗组，LTG））来评估延长干扰素-α（IFN）治疗对丁型肝炎病毒（HDV）所致儿童慢性肝炎的疗效。治疗的依从性和耐受性良好。治疗结束时，12名儿童出现完全生化反应[丙氨酸氨基转移酶（ALT）恢复正常]（MTG组13例中有5例，LTG组13例中有7例）。10例患者在停用干扰素后复发（MTG组和LTG组各5例）。LTG组有2例患者在12个月的随访期间肝功能检查正常。8例乙肝e抗原（HBeAg）阳性儿童中有6例HBeAg消失，而所有6例乙肝病毒（HBV）DNA阳性患者在治疗期间HBV DNA均消失。2例儿童后来HBeAg再次出现。MTG组10/10例治疗前存在HDV RNA，12个月干扰素治疗后，10例中有3例仍持续存在。停药一年后，10/10例患者HDV RNA再次阳性。2例儿童肝脏中清除了丁型肝炎抗原（HDVAg）。两组肝脏组织学均未见明显改善。我们的经验表明，α-干扰素治疗儿童慢性丁型肝炎有短暂疗效，长期治疗在生化和病毒学反应方面似乎并未带来更大的治疗益处。
