Chronic hepatitis B virus in children in Israel: Clinical and epidemiological characteristics and response to interferon therapy

R. Neudorf-Grauss, Y. Bujanover, G. Dinari, E. Broide, Y. Neveh, I. Zahavi, S. Reif

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe the clinical and epidemiological features of hepatitis B virus infection in Israeli children, and to evaluate their response and compliance to therapy. Methods: We retrospectively studied 51 patients (34 males, 17 females), aged 2-18 years, from several medical centers in Israel. Results: Of the 51 patients, 38 with elevated transaminase, positive hepatitis B e antigen and/or HBV DNA, and histologic evidence of liver inflammation were treated. Interferon was administered by subcutaneous injections three times a week for 3-12 months (dosage range 3-6 MU/m2). Only 16% were native Israelis, while 78% of the children were of USSR origin. A family history of HBV infection was recorded in 25 of the 51 patients (9 mothers, 16 fathers or siblings). Five children had a history of blood transfusion. The histological findings were normal in 3 patients, 24 had chronic persistent hepatitis, 14 had chronic active hepatitis and 2 had chronic lobular hepatitis. Five children also had anti-hepatitis D virus antibodies. Twelve of the 38 treated patients (31.5%) responded to IFN completely, with normalization of the transaminase levels and disappearance of HBeAg and HBV DNA. In no patient was there a loss of hepatitis B surface antigen. The main side effects of IFN were fever in 20 children, weakness in 10, headaches in 9, and anorexia in 6; nausea, abdominal pain, and leukopenia were present in 3 cases each. The response rate was not affected by age, country of origin, alanine/aspartate aminotransferase levels, or histological findings. However, a history of blood transfusion was a predictor of good response, 60% vs 27% (P<0.05). Conclusions: We found IFN to be a safe and adequate mode of treatment in children with chronic HBV infection, regardless of their liver histology and transminase levels. Therefore, in view of the transient side effects associated with this drug, we recommend considering its use in all children with chronic hepatitis B.

Original languageEnglish
Pages (from-to)164-168
Number of pages5
JournalIsrael Medical Association Journal
Volume2
Issue number2
StatePublished - 2000
Externally publishedYes

Keywords

  • Hepatitis B virus
  • Side effects
  • Transaminase levels
  • Transmission

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