The Turkish Journal of Pediatrics 2010 , Vol 52 , Num 5
Efficacy of Combined Interferon Alpha and Long-Term Lamivudine Therapy in Children with Chronic Hepatitis B
Departments of Pediatric Gastroenterology, Hepatology and Nutrition, and 2Pathology, Ankara University Faculty of Medicine, Ankara, Turkey Kuloglu Z, Kansu A, Erden E, Girgin N. Efficacy of combined interferon alpha and long-term lamivudine therapy in children with chronic hepatitis B. Turk J Pediatr 2010;52: 457-463.

The aim of this study was to evaluate the efficacy of interferon alpha (IFN-a) and long-term lamivudine therapy in children with chronic hepatitis B and to determine the optimal duration of lamivudine therapy. Thirty-eight HBeAg-positive children simultaneously received IFN-a2a 5 MU/m2 to 10 MU/m2 for six months and lamivudine (4 mg/kg/day). Lamivudine was administered until anti-HBe seroconversion and was continued for six months in responders. During the five-year study period, we evaluated the efficacy of treatment, occurrence of YMDD mutants and adverse effects. During the study period, alanine aminotransferase (ALT) normalization, clearance of hepatitis B virus (HBV) DNA, HBeAg/anti-HBeAb, HBsAg/anti-HBsAb seroconversion, and histological response were noted in 27 (71.1%), 14 (36.8%), 13 (34.2%), 2 (5.2%) and 10 (47.9%) patients, respectively. Complete response was determined in 34.2% (13/38), and in 69.2% of these responders, response was achieved within 18 months. Breakthrough and YMDD mutant rates were 65.8% and 55.2%, respectively. Breakthrough time was a median 24 months and was associated with low baseline ALT level (p<0.01). In conclusion, although lamivudine was used for a longer period, the response rate was not higher than in previous reports. We suggest that 18 months' duration of lamivudine treatment is sufficient for combination therapy. Keywords : interferon, lamivudine, chronic hepatitis B, children

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