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Ewa Majda-Stanisławska, Iwona Szaflik, Aleksandra Omulecka
Med Sci Monit 2000; 6(6): CR1142-1147
Thirty two children (8 girls and 32 boys), aged 4-14, with chronic hepatitis C were treated with interferon alpha at a dose of 3 MU or 5 MU, given times weekly for 6 months. Five children (16%) were complete responders (defined as disappearance of viremia), none of them relapsed, 6 (19%) were partial responders (normalization of ALT), 3 (9%) were transient responders (ALT initially decreased but then rebounded to pre-treatment levels) and 18 (56%) were non-responders. During the treatment, continuous decrease of median ALT, AST and GGT was noted, statistically significant differences were found for comparisons of values measured before and after treatment (for ALT p=0.023, for AST p=0.021 and for GGT p=0.012). Histological evaluation revealed one case of progression (to liver cirrhosis) out of three investigated complete responders, 1/5 such cases of partial responders, 1/2 of transient responders and 14/18 of non-responders. Remission of hepatitis was found in 2/18 (10%) non-responders. There was no statistically significant difference between 16 children previously infected with HBV (anti-HBc positive but HBsAg negative at the time of our study) and the others with respect to biochemical and histological severity of hepatitis or in the response to treatment rate. Conclusions: Chronic hepatitis C in children may cause severe hepatitis or even liver cirrhosis. Virological, biochemical and histological features should be considered to evaluate the severity of the disease and response to interferon treatment. Past infection with HBV does not affect interferon sensitivity in children with chronic hepatitis C.