Interferon-alpha treatment of chronic hepatitis B in childhood: A consensus advice based on experience in European children

Background: The efficacy of interferon (IFN) in children with chronic hepat itis B has been evaluated in randomized controlled trials over the past dec ade but recommendations for treatment based on this experience have not bee n published yet. The purpose of this workshop, held in Madrid in October 19 97, was to provide pediatricians with guidelines for practical use of IFN i n hepatitis B. Methods: Eighteen European pediatricians and hepatologists agreed to report and discuss their experience on 1,122 treated children, 40% of whom were c onsidered responders. Results: Agreement was obtained on the following main items: 1) rationale f or treatment is to accelerate hepatitis B early antigen (HBeAg) clearance i n a subgroup of patients; 2) candidates for treatment are children with HBe Ag and HBV DNA positivity, with low-intermediate HBV DNA levels and abnorma l alanine aminotransferase values, aged 2 years or more; 3) IFN is contrain dicated in children with decompensated liver disease, cytopenia, severe ren al or cardiac disorders, and autoimmune disease; 4) the standard treatment regimen is 5 mU/m(2) thrice weekly for 6 months, Retreatment in nonresponde rs is not indicated. Conclusions: A consensus was obtained on the use of IFN in children with he patitis B, based on its short-term efficacy. The long-term clinical and vir ological effects of the drug, however, remain to be evaluated.