Affiliations: Department of Pediatric Hepatology, National Liver
Institute, Menofiya University, Egypt | Department of Pathology, National Liver Institute,
Menofiya University, Egypt | Department of Microbiology, National Liver Institute,
Menofiya University, Egypt
Note: [] Correspondence: Mostafa M. Sira MD, Department of Pediatric
Hepatology, National Liver Institute, Menofiya University, 32511 Shebin
El-koom, Menofiya, Egypt. Tel.: +2 048 2222740; Fax: +2 048 2234586; E-mail:
msira@liver-eg.org
Abstract: Chronic hepatitis C has been described as a mild disease in
children, but fibrosis progression and end stage liver disease have been
documented. Thus, the problem of therapy has become a challenging issue. Our
preliminary results using the standard treatment regimen of alternate day
interferon (IFN) plus ribavirin yielded 21.4% sustained virological response (SVR). In this study,
we evaluate the efficacy and safety of daily IFN alpha-2a induction regimen
plus ribavirin in treatment of children with chronic hepatitis C genotype 4.
The study included 40 children with chronic hepatitis C. Thirty patients were
naive hepatitis C and 10 were previously non-responders to the standard
treatment regimen. All children were assigned to receive daily IFN plus
ribavirin for 1 month, then alternate day IFN plus ribavirin for 11 months. The
mean age of children was 11.7 ± 0.35 years and 27
(67.5%) were males. Twenty-nine (72.5%) had low, three (7.5%) moderate
and eight (20%) high viremia. Thirty-four (85%) had rapid virological
response and 33 (82.5%) had SVR. One patient had a breakthrough at 6~months
duration of therapy. Adverse effects were mild, and were not treatment
limiting. Low viral load was significantly associated with higher rate of SVR.
Rapid virological response had 90% positive predictive value for subsequent
SVR with 100% sensitivity. Daily IFN induction regimen showed a high
efficacy and safety for treatment of children with chronic hepatitis C virus genotype 4.
