Gottrand F, Michaud L, Guimber D, Ategbo S, Dubar G, Turck D, Farriaux J P
Service de Pédiatrie, Hôpital Huriez, CHRU de Lille, France.
Eur J Pediatr. 1996 Dec;155(12):1031-4. doi: 10.1007/BF02532525.
Anorexia and weight loss are frequently reported as adverse effects during recombinant interferon alpha (rIFN-alpha) treatment. The aim of the present study was to assess both nutritional status and growth of children and adolescents treated with rIFN-alpha for chronic viral hepatitis. Eleven patients aged 4-16 years with histologically proven chronic active hepatitis (hepatitis B, n = 9; hepatitis C, n = 2) receiving rIFN-alpha subcutaneously thrice a week for 6 months were studied. Weight and height increments were assessed during the 6 months before starting rIFN-alpha. Weight and height were measured every 3 months (M0, M3, M6) during the 6 months of rIFN-alpha treatment, then every 6 months during the follow up period (6-36 months). Weight decreased in every child during rIFN-alpha treatment (weight loss varies from 0.5 to 2.6 kg after 3 months of treatment). Weight/age Z-score decreased from 0.12 at M0 to -0.69 at M3 (P < 0.01), then increased between M3 and M6 (-0.33) (P < 0.01), but normalized (0.02) only 6 months after completion of treatment. Nutritional status was significantly impaired during treatment (Z-score for weight/height decreased from 0.18 at M0 to -0.74 at M3, P < 0.01) and recovered progressively thereafter. Height and height velocity were not modified by rIFN-alpha treatment. A reduction of the caloric intake observed between M0 and M3 might explain these features.
Significant but transient abnormalities of the nutritional status are encountered constantly at the beginning of rIFN-alpha therapy without any deleterious effect on growth. Information of the families and nutritional intervention during treatment should be required, in order to limit the importance of weight loss.
厌食和体重减轻是重组干扰素α(rIFN-α)治疗期间常见的不良反应。本研究旨在评估接受rIFN-α治疗慢性病毒性肝炎的儿童和青少年的营养状况及生长情况。研究对象为11例4 - 16岁经组织学证实为慢性活动性肝炎的患者(乙型肝炎9例,丙型肝炎2例),他们每周皮下注射rIFN-α三次,共6个月。在开始rIFN-α治疗前的6个月评估体重和身高增长情况。在rIFN-α治疗的6个月期间,每3个月(M0、M3、M6)测量体重和身高,随后在随访期(6 - 36个月)每6个月测量一次。在rIFN-α治疗期间每个儿童的体重均下降(治疗3个月后体重减轻0.5至2.6千克)。体重/年龄Z评分从M0时的0.12降至M3时的 - 0.69(P < 0.01),然后在M3至M6之间升高( - 0.33)(P < 0.01),但仅在治疗结束6个月后恢复正常(0.02)。治疗期间营养状况明显受损(体重/身高Z评分从M0时的0.18降至M3时的 - 0.74,P < 0.01),此后逐渐恢复。rIFN-α治疗未改变身高及身高增长速度。M0至M3期间观察到的热量摄入减少可能解释了这些特征。
在rIFN-α治疗开始时经常会出现明显但短暂的营养状况异常,对生长无任何有害影响。应告知家属相关信息并在治疗期间进行营养干预,以减轻体重减轻的影响。