만성 B형간염 환아에 대한 Interferon-alpha 치료결과의 장기 추적관찰
Long Term Follow Up of Interferon-alpha Treatment in Children with Chronic Hepatitis B
백승연, 엄지현, 정기섭,
소속 상세정보
백승연 ( Baek Seoung-Yon )
연세대학교 의과대학 소아과학교실
엄지현 ( Uhm Ji-Hyun )
연세대학교 의과대학 소아과학교실
정기섭 ( Chung Ki-Sup )
연세대학교 의과대학 소아과학교실
KMID : 0816120030060020140
Abstract
Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in, children with chronic hepatitis B.
Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was 11.1±4.1 years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of 3 x 10^(6) unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done.
Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and I out of 3 with interferon retreatment.
Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.
키워드
Children;Chronic hepatitis B;Interferon-alpha;Predictive factor;Lamivudine
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