INFLUENCE OF RECOMBINANT INTERFERON-ALPHA ON NUTRITIONAL-STATUS AND GROWTH-PATTERN IN CHILDREN WITH CHRONIC VIRAL-HEPATITIS

Anorexia and weight loss are frequently reported as adverse effects du ring recombinant interferon alpha (rIFN-alpha) treatment. The aim of t he present study was to assess both nutritional status and growth of c hildren and adolescents treated with rIFN-alpha for chronic viral hepa titis. Eleven patients aged 4-16 years with histologically proven chro nic active hepatitis (hepatitis B, n = 9; hepatitis C, n = 2) receivin g rIFN-alpha subcutaneously thrice a week for 6 months were studied. W eight and height increments were assessed during the 6 months before s tarting rlFN-alpha. Weight and height were measured every 3 months (M0 , M3, M6) during the 6 months of rIFN-alpha treatment, then every 6 mo nths during the follow up period (6-36 months). Weight decreased in ev ery 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 M 6 (-0.33) (P < 0.01), but normalized (0.02) only 6 months after comple tion of treatment. Nutritional status was significantly impaired durin g 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 an d height velocity were not modified by rTFN-alpha treatment. A reducti on of the caloric intake observed between M0 and M3 might explain thes e features. Conclusion Significant but transient abnormalities of the nutritional status are encountered constantly at the beginning of rIFN -alpha therapy without any deleterious ef feet on growth. Information of the families and nutritional intervention during treatment should b e required, in order to limit the importance of weight loss.