Copyright ©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Jan 14, 2012; 18(2): 99-104
Published online Jan 14, 2012. doi: 10.3748/wjg.v18.i2.99
Table 1 Sustained viral response in five representative prospective trials using polyethylene glycol-interferon alpha-2b and polyethylene glycol-interferon alpha-2a in combination with ribavirin and stratified for different clinical and laboratory parameters and genotypes, published between 2005 and 2011
Wirth 20051Jara 20081Wirth 20101Total PEG-interferon a-2b trialsSchwarz 20112Sokal 20102Total all trials
Dosage1.5 μg/kg per week1.0 μg/kg per week60 μg/m² per week180 μg/1.73 m²per week100 μg/m² per week
Total (%)36/61 (59)15/30 (50)70/107 (65.4)121/198 (61.1)29/55 (53)43/65 (66.1)193/318 (60.7)
Genotype (%)
122/46 (48)12/26 (46)38/72 (53)72/144 (50)21/45 (47)27/47 (59)120/236 (51)
2/313/13 (100)3/3 (100)28/30 (93)44/46 (96)8/10 (80)16/17 (94)68/73 (93)
41/20/14/5 (80)5/8 (62)Included in G1
ALT-levels (%)
Elevated12/25 (48)27/44 (61)19/33 (58)58/102 (57)
Normal24/36 (67)42/63 (67)24/30 (80)90/129 (70)
Mode of infection (%)
Parenteral19/27 (70)7/9 (78)5/5 (100)31/41(76)
Genotype 113/21 (62)1/1
Vertical12/25 (48)8/21 (38)46/75 (61)66/121 (55)
Genotype 17/20 (35)26/52 (50)33/72 (46)
Break through9.8%6/41 (15)
Relapse7.7%8%6/35 (17)
Table 2 Most frequent adverse events during polyethylene glycol-interferon treatment in combination with ribavirin and its appraisal of clinical significance
Interferon α-treatment:
Leukopenia, thrombocytopenia: Frequent, not really significant; if necessary dose reduction
Flu-like symptoms: In all treated patients, not significant
Alopecia: Not significant
Autoimmune thyroiditis: At least 15 %, significant, mostly reversible
Acute psychosis, depression: Very seldom before puberty (< 1 %), rare in adolescents, significant in cases with manifestation; should be under investigation in future trials
Growth delay: Clinically not significant, catch-up growth, but under investigation with relative high priority
Anorexia, weight loss: Mostly not significant with exceptions, normalisation after therapy stop
Anemia: Mostly clinically not significant with exceptions, reversible
Table 3 Indication for hepatitis C virus treatment in children-pros and cons
In favour of treatmentDeferral might be considered
High response rate, sustained viral response means cure of the diseaseBefore 3-4 years of age because of possible spontaneous viral elimination
Prevention of disease progression and social burdenPsychiatric disorder
Better tolerability and less side effects in younger patients (particularly before puberty)Low response rate in subjects with genotype 1 and high viral load
More favourable factors for response in children (e.g., low viral load)Pubertal growth spurt
Parents facilitate complianceMore effective treatments in future in genotype 1 non-responders