TREATMENT OF CHRONIC HEPATITIS-B IN CHILDREN WITH PREDNISOLONE WITHDRAWAL FOLLOWED BY RECOMBINANT INTERFERON-ALPHA

Steroid withdrawal followed by interferon therapy is an alternative ap proach for treating chronic hepatitis B virus infection when there has been no therapeutic response to interferon alone. The effectiveness o f steroid withdrawal followed by interferon therapy and factors predic tive of the response were evaluated in 35 children with biopsy-proven chronic hepatitis B. Patients had received a 1-month course of prednis olone, 1 mg/kg per day orally, followed by a 2-week rest, and then wer e treated with interferon alpha 3 MU three times per week for 4-6 mont hs. The serum aminotransferase values normalized in 80%, and negative seroconversion rates of HBeAg and HBV-DNA Mere 69% and 66%. The good r esponse rate was associated with a pretreatment HBV-DNA level lower th an 100 pg/ml and a posttreatment ALT level more than 200 IU/L. Normali zation of ALT values usually took 5 months; and the clearance of HBV/- DNA and HBeAg took 7.8 and 6.7 months respectively. These results sugg est that steroid withdrawal followed by interferon therapy is useful i n the treatment of chronic hepatitis B in children, and that a good re sponse rate can be expected in children with lower pretreatment HBV-DN A levels (<100 pg/ml).