Interferon treatment for chronic hepatitis B: Enhanced response in children 5 years old or younger

Objective To test the hypothesis that there is an improved response to interferon in children with chronic hepatitis B (HBV) who are less than or equal to5 years of age. Study design Retrospective chart review of 22 consecutive children with chronic HBV (ages 17 months to 17 years; median, 83.9 months; 14 male, 8 female) treated with interferon-alpha2b. Results Ten patients (48%) responded to treatment [HBeAg (-), Anti-HBe (+), HBV DNA (-), HBsAg (+) and normal alanine aminotransferase/aspartate aminotransferase (ALT/AST) at 6 months after treatment], and 5 seroconverted HBsAg [above plus HBsAg negative and anti-HBs (+)]. Seven of 9 patients (78%) less than or equal to5 years of age responded (5 cleared HBsAg). Three of 13 patients (23%) >5 years of age responded. Patient age at treatment was significantly lower in responders (63 +/- 70 months) versus nonresponders (104 +/- 55 months, P = .005). AST, ALT, and HBV DNA at the start of treatment were not different between responders and nonresponders or between patients less than or equal to5 and >5 years old. Conclusions Interferon treatment may be more effective in younger children with chronic hepatitis B.