Treatment of chronic hepatitis C in children with pegylated interferon and ribavirin : the impact of dose

Introduction: In the last years children with chronic hepatitis C (CHC) have been treated with Pegylated Interferon α (PEGIFNα) and ribavirin (RBV). Treatment can cause several side effects that require reduction or interruption of therapy. The relationship between dose of PEG-IFNα and response to therapy has not been clearly evaluated. Aim of this study was to evaluate the impact of the dose of PEG-IFNα2b and RBV on the efficacy of therapy. Patients and method: All children with CHC treated with PEGIFNα2b and RBV, observed at the Paediatric Liver Unit of University Federico II of Naples from 1996 to 2006 were evaluated. Results: Sixteen children with CHC treated with combined therapy were enrolled. Seven out of 16 patients (43.7%) achieved rapid virological response; 13/16 patients (81.2%) achieved early virological response; 5/16 patients (31.25%) relapsed; 1 patient resulted non responder. According to percentage of expected dose, our patients were divided into two groups: the first group included 7 patients that performed an overall dosage of PEG-IFNα2b ≥ 75% of the scheduled full dose; the second group included 9 patients that performedm PEG-IFNα2b dose < 75% of scheduled full dose. No difference was noted in terms of sustained virological response. Conclusion: Modifications of therapy due to PEG-IFNα-related adverse events are frequent in children with CHC, but dose adjustments do not seem to impair efficacy of therapy.