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KMID : 0816119980010010079
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Korean Journal of Pediatric Gastroenterolology and Nutrition
1998 Volume.1 No. 1 p.79 ~ p.89
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Combined Therapy of Alfa-Interferon and Thymodulin on Children with Chronic Active Hepatitis B
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Choe Byung-Ho
Ko Cheol-Woo
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Abstract
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Purpose: Though many antiviral or immunomodulatory agents have been used in
patients with chronic HBV hepatitis, interferon is considered to be the only effective
therapeutic agent so far. Among immunomodulatory agents, thymodulin, the oral form of
thymosin, is currently in clinical trial. We compared the efficacy of alfa-interferon
therapy alone with a combined therapy of alfa-interferon and thymodulin in children
with chronic active hepatitis B.
Method: Twenty three children aged 4.4∼13.7 years who were known to be positive
for HBsAg and HBeAg in serum for at least 6 months and who had biopsy-proven
chronic active hepatitis were given either combined therapy of alfa-interferon and
thymodulin or alfa-interferon alone, and all children were HBV DNA positive in their
serum at the beginning. Follow-ups have been done for at least 1 year after a 6 month
course of therapy and clearance of viral replication markers has been evaluated.
Results: 1) During follow up period, 11 (48%) children were seroconverted to anti-HBe
and were cleared of HBV DNA from their serum. However, 2 of them relapsed after
discontinuance of interferon therapy.
2) Seroconversion occurred more frequently among those who had not been vertically
transmitted, had elevated serum ALT levels and low HBV DNA levels before interferon
therapy.
3) There was no significant advantage of the combined therapy with thymodulin
compared to interferon therapy alone.
Conclusion: Combined therapy of alfa-interferon and thymodulin failed to demonstrate
synergistic effect. We think that combination therapies of alfa-interferon with other
antiviral or immunomodulatory agents need to be studied in order to achieve better
therapeutic responses.
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KEYWORD
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Chronic hepatitis B, Interferon, Thymodulin, Children,
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