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Effect of recombinant alpha 2 interferon with or without prednisone in Chinese HBsAg carrier children

By CL Lai, HJ Lin, JYN Lau, ASFPC Lok Wu, HT Chung, LSK Wong, MP Leung and CY Yeung

Abstract

Ninety Chinese hepatitis B surface antigen (HBsAg) carrier children, aged 2-17 years, positive for hepatitis B e antigen (HBeAg) and hepatitis B virus DNA on at least three occasions in 6 months, were randomized into 3 groups. Thirty children received syrup vitamin B complex as control, 29 received 6 weeks of placebo syrup followed by 16 weeks of recombinant α(2b)-interferon [intron A (rIFN(2b))], 5 x 10 6 u/m 2 subcutaneously thrice weekly; and 31 received 6 weeks of syrup prednisone (0.6 mg/kg tailed to 0.2 mg/kg) followed by 16 weeks of recombinant α(2b)-interferon as above. The placebo/prednisone syrup was given on a double-blind basis. At 24 months of follow-up, persistent loss of hepatitis B virus DNA occurred in none of the children in the control group, in one child receiving recombinant α(2b)-interferon alone, who also seroconverted to anti-HBe and anti-HBs and in five children receiving interferon with steroid priming (p = 0.0571 compared with controls), with four seroconverting to anti-HBe and one also seroconverting to anti-HBs. A rise of transaminases to above twice the upper limit of normal levels during the first 7 months of follow-up occurred in one subject in the control group, four in the group receiving α(2b)-interferon alone and nine in the group receiving recombinant α(2b)-interferon with steroid priming (p = 0.0144 compared with controls). Side effects of the steroid were negligible; those of recombinant α(2b)-interferon were transient and acceptable. We conclude that 6 weeks of prednisone followed by 16 weeks of recombinant α(2b)-interferon is of use in inducing persistent loss of hepatitis B virus DNA (16.1 per cent) and e-seroconversion (12.9 per cent) in a proportion of Chinese HBsAg carrier children: the prednisone probably enhances the immunomodulatory effect of recombinant α(2b)-interferon.link_to_subscribed_fulltex

Topics: Adolescent, Carrier State - Microbiology - Therapy, Child, Child, Preschool, China, Dna, Viral - Analysis, Double-Blind Method, Female, Hepatitis B - Microbiology - Therapy, Hepatitis B Surface Antigens - Analysis, Hepatitis B E Antigens - Analysis, Hepatitis B Virus - Isolation & Purification, Humans, Interferon-Alpha - Therapeutic Use, Male, Prednisone - Therapeutic Use, Recombinant Proteins
Year: 1991
OAI identifier: oai:hub.hku.hk:10722/161886
Provided by: HKU Scholars Hub
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