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KMID : 0367420050480010055
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Journal of Korean Pediatric Society
2005 Volume.48 No. 1 p.55 ~ p.62
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Comparison of Therapeutic Efficacy between Lamivudine and Alpha-Interferon in Korean Children with Chronic Hepatitis B at Two Years after the Initiation of Treatment
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Choe Byung-Ho
Jang You-Cheol
Jang Chang-Hwan
Oh Ki-Won
Lee Jun-Hwa
Ko Cheol-Woo
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Abstract
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Purpose : We compared the therapeutic efficacy of lamivudine and alpha-interferon in children with chronic hepatitis B two years after the initiation of treatment, so that we could verify the safety and long term efficacy of lamivudine in children.
Methods : We prospectively studied 44 children(32 male and 12 female; age, 1-18 years, mean, 9 years) treated for chronic hepatitis B from September 1996 to June 2004 in Kyungpook National University Hospital in Korea. Twenty three children were treated with interferon, and 21 with lamivudine. Treatment efficacy was defined as the normalization of ALT and hepatitis B virus(HBV) DNA levels, loss of HBsAg and HBeAg seroconversion at two years after the initiation of treatment.
Results : Among the 23 children treated with interferon, the ALT level normalized in 10 children(43 %) and HBV DNA was undetectable in 12 children(52%). HBsAg was undetectable in one child (4 %) and HBeAg seroconversion occurred in nine children(39%) two years after the initiation of treatment. In comparison, among the 21 children treated with lamivudine, ALT normalized in 20 children (95%), HBV DNA in 19(90%), HBsAg in 5(24%), and HBeAg seroconversion occurred in 13(62%). Above all, in the lamivudine treated group under the age of seven, HBeAg and HBsAg seroconversion occurred in six(75%) and five(63%) out of the eight children respectively, which showed superior HBsAg seroconversion rate if treated in preschool aged children.
Conclusion : We believe that the therapeutic efficacy of lamivudine in children with chronic hepatitis B could be better than interferon with fewer side effects, especially in preschool aged children.
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KEYWORD
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Chronic hepatitis B, Children, Interferon, Lamivudine, Hepatitis B e antigens, Hepatitis B s antigens, Seroconversion, Treatment
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