RECOMBINANT INTERFERON-ALPHA(2A) HASTENS THE RATE OF HBEAG CLEARANCE IN CHILDREN WITH CHRONIC HEPATITIS-B

We conducted a prospective controlled study of the efficacy of recombi nant interferon-alpha(2a) in 77 children (44 boys, 33 girls, mean age 8 yr) with chronic hepatitis B. All patients had seropositive results for HBeAg and hepatitis B virus DNA; 52 had chronic persistent or nons pecific reactive hepatitis, and 25 had mild active hepatitis. Twenty-o ne children (group 1) received recombinant interferon-alpha(2a) 7.5 me gaunits/m(2) three times weekly for 6 mo, 19 children (group 2) receiv ed megaunits/m(2) on the same schedule and 37 (group 3) remained untre ated. At 6 mo, HBe antigen-to-antibody seroconversion associated with biochemical remission was seen in 24% of patients in group 1, 5% in gr oup 2 and 3% in group 3 (p < 0.05 vs. group 1). At 18 mo, seroconversi on rates were 30% in group 1, 21% in group 2 and 13.5% in group 3. The se results suggest that a course of recombinant interferon-alpha(2a) a ccelerates HBeAg-HBe antibody seroconversion in children. High baselin e ALT levels were sensitive predictors of seroconversion in both treat ed and untreated patients. In contrast, baseline IgM HBc antibody leve ls influenced the rate of anti-HBe seroconversion only in untreated pa tients. These findings suggest that, in children as well as in adults, recombinant interferon-alpha(2a) favors the clearance of hepatitis B virus replication, enhancing the host antiviral immunoresponse.