Document Detail

Liver histology of children with chronic hepatitis treated with interferon-alpha alone or in combination with lamivudine.
MedLine Citation:
PMID:  18030234     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate histological changes with interferon monotherapy or interferon plus lamivudine combination therapy in children with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. PATIENTS AND METHODS: 31 children aged 2-13 years were randomly treated with interferon (IFN) (group 1, n = 16) or IFN plus simultaneously started lamivudine (group 2, n = 15). IFN-alpha 2a was given 9 MU/m2 3 times per week for 6 months in each group; lamivudine was given 4 mg x kg(-1) x day(-1) for 24 months. Liver biopsy specimens were evaluated according to the Knodell score before therapy and after 24 months of therapy. Histological response was defined as a decrease in the histological activity index (HAI) score by at least 2 points. Efficacy of therapy was evaluated at 24 months of therapy in all children. RESULTS: Alanine aminotransferase normalization, HbeAg, and hepatitis B virus DNA clearance were not different. Complete response and histological response were 37.5%/62.5% and 40%/46.7% in groups 1 and 2, respectively (P = NS). At baseline and at 24 months of therapy, total HAI and components of HAI were not different in the 2 groups. In comparison with baseline, a significant decrease in scores of periportal +/- bridging necrosis was observed in group 1 (P = 0.01); periportal +/- bridging necrosis, intralobular degeneration, focal necrosis, and necroinflammation scores significantly decreased in group 2 (P = 0.04 and P = 0.02) at 24 months of therapy. CONCLUSIONS: The addition of lamivudine to IFN-alpha did not increase the effectiveness of the treatment in terms of complete and histological responses. Both therapies seemed to be effective in the regression of periportal +/- bridging necrosis. In addition, combination therapy was also effective in the regression of intralobular degeneration, focal necrosis, and necroinflammatory activity index.
Zarife Kuloglu; Ceyda Tuna Krsaçloglu; Aydan Kansu; Esra Erden; Nurten Girgin
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  45     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-21     Completed Date:  2008-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  564-8     Citation Subset:  IM    
Department of Pediatric Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
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MeSH Terms
Anti-HIV Agents / therapeutic use*
Antiviral Agents / therapeutic use*
Child, Preschool
Drug Therapy, Combination
Follow-Up Studies
Hepatitis, Chronic / drug therapy*,  pathology
Interferon-alpha / therapeutic use*
Lamivudine / therapeutic use*
Liver / drug effects,  pathology*
Prospective Studies
Treatment Outcome
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antiviral Agents; 0/Interferon-alpha; 134678-17-4/Lamivudine

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