Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Lackner, H; Moser, A; Benesch, M; Deutsch, J; Kessler, HH; Kerbl, R; Schwinger, W; Dornbusch, HJ; Sovinz, P; Urban, C.
Serological and molecular response on combined antiviral treatment in children with chronic hepatitis B after pediatric malignancy.
J Clin Virol. 2002; 25 Suppl 3:S73-S79
Doi: 10.1016/s1386-6532(02)00189-0
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- Führende Autor*innen der Med Uni Graz
- Lackner Herwig
- Co-Autor*innen der Med Uni Graz
- Benesch Martin
- Deutsch Johann
- Dornbusch Hans Jürgen
- Kerbl Reinhold
- Kessler Harald
- Nebl Andrea Maria
- Ritter-Sovinz Petra
- Schwinger Wolfgang
- Urban Ernst-Christian
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- Abstract:
- Chronic hepatitis B is a serious long-term problem for children surviving malignancy. The annual rate of spontaneous clearance of hepatitis B e antigen (HBeAg) is only 3% in these patients, and the response to monotherapy with interferon (IFN)-alpha is also low. To monitor the serological and molecular response on combined antiviral treatment in children with chronic hepatitis B after pediatric malignancy. Twelve patients with a history of childhood malignancy and chronic hepatitis B were treated with prednisone for 4 weeks (0.6 mg/kg body weight per day orally for 3 weeks followed by 0.3 mg/kg body weight per day for 1 week) followed by IFN-alpha-2a (5 megaunits/m(2) body surface area, three times a week, subcutaneously) at least for 1 year. After 1 year of IFN-alpha monotherapy, treatment was discontinued in patients with HBeAg seroconversion as well as patients without HBeAg seroconversion and a decrease of serum hepatitis B virus (HBV) DNA level less than 0.5 logs of the basal level. Patients who had a decrease of the serum HBV DNA of more than 0.5 logs of the basal level underwent treatment continuation with IFN-alpha combined with famciclovir (FAM) (20 mg/kg body weight per day orally) for another year. After 1 year of IFN-alpha monotherapy, a decrease of the serum HBV DNA level to less than 0.5 logs was found in eight of 12 patients. Two of them additionally developed HBeAg seroconversion after 3 and 12 months. The remaining six patients received antiviral treatment with IFN-alpha combined with FAM for another year. Two of them showed HBeAg seroconversion after 21 and 24 months from study entry. HBeAg seroconversion was only observed in patients who had a decrease of serum HBV DNA to levels below 1 x 10(6) copies/ml. Treatment-induced toxicity was moderate and reversible in all patients. Combination treatment of chronic hepatitis B with prednisone, IFN-alpha, and FAM seems to be a safe and effective treatment option for children surviving pediatric malignancy.
- Find related publications in this database (using NLM MeSH Indexing)
- 2-Aminopurine - analogs & derivatives
- 2-Aminopurine - therapeutic use
- Adolescent -
- Antiviral Agents - adverse effects
- Antiviral Agents - therapeutic use
- Child -
- Child, Preschool -
- DNA, Viral - analysis
- Drug Therapy, Combination -
- Evaluation Studies as Topic -
- Famciclovir -
- Female -
- Hematologic Neoplasms - complications
- Hepatitis B, Chronic - drug therapy
- Hepatitis B, Chronic - immunology
- Hepatitis B, Chronic - virology
- Humans -
- Interferon alpha-2 -
- Interferon-alpha - administration & dosage
- Interferon-alpha - adverse effects
- Interferon-alpha - therapeutic use
- Male -
- Prednisone - administration & dosage
- Prednisone - adverse effects
- Prednisone - therapeutic use
- Recombinant Proteins -
- Safety -
- Serotyping -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- chronic hepatitis B
- children
- HBV DNA
- seroconversion
- interferon
- famciclovir