Abstract
Background
Effective management of children with chronic hepatitis B is still an unresolved issue.
Aim
To assess the outcome of different therapeutic regimens among children with HBeAg-positive
chronic hepatitis B.
Methods
Electronic database searches identified clinical trials that completed specific periods
of treatment and follow-up. Sustained response rates were defined by the loss of HBV
DNA and HBeAg, and by the normalization of liver enzymes. The loss of HBsAg and seroconversion
to anti-HBs were also listed.
Results
Our searches found 20 eligible articles (1112 enrolled patients, 2–18 years old).
Interferon-alpha therapy showed significantly higher sustained response rate and loss
of HBsAg than no therapy (Odd's ratio 3.0, 95% confidence interval 1.6–5.4; and 2.3,
1.1–11.3, respectively). The sustained response rate was not significantly different
between interferon and interferon plus lamivudine, or plus prednisone, or plus hepatitis
B vaccine; this rate was significantly higher for interferon compared with combined
interferon plus levamisole or vitamin E.
Conclusion
Interferon-alpha is still the most effective treatment option for children with HBeAg-positive
chronic hepatitis B. Randomized trials are warranted for further comparing interferon
to newer antiviral agents in terms of efficacy, safety, emergence of mutant variants,
and cost/benefit ratio.
Keywords
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Article info
Publication history
Published online: September 04, 2014
Accepted:
August 3,
2014
Received:
January 9,
2014
Identification
Copyright
© 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
