Mono- vs. Combination Therapy for Pediatric Hep B: Which is Better?
SAN DIEGO, CA—No significant differences were found between lamivudine monotherapy, interferon-alpha monotherapy, or combination lamivudine + interferon therapy among treatment-naïve children with chronic hepatitis B infection, but spontaneous seroconversion was more common among older children, reported authors of a retrospective study presented at IDWeek 2015.
“No statistically significant difference was found in terms of response to treatment between the three different treatments,” reported Emine Kocabas, MD, a professor at Çukurova University in Adana, Turkey, and coauthors.
Dr. Kocabas and coauthors evaluated 403 treatment-naïve children with chronic hepatitis B infection who were followed up at outpatient pediatric infectious disease clinics from January 2004 to December 2013. The presence of hepatitis B in families was 82.6%.
Of the 403 children enrolled, 31.2% (n=126) of children experienced spontaneous seroconversion during their 10-year follow-up period, Dr. Kocabas reported. Spontaneous seroconversion was associated with older age (median age at diagnosis, 9.9 years vs. 8.5 years; P<0.01), Dr. Kocabas said.
The three treatment groups consisted of monotherapy (Group I and Group II) and combination therapy (Group III). In Group I, 35 patients received interferon-alpha (IFN-α) monotherapy for 6 months; in Group II, 29 patients received lamivudine monotherapy (4mg/kg) for 12 months; and the 101 patients in Group III received lamivudine for 12 months, with IFN-α for the first 6 months. Patients in the study arms had significant baseline differences in mean age (P<0.05), mean ALT (P<0.01), and fibrosis score (P<0.01), Kocabas reported.
No statistically significant difference was observed in responses between these 3 regimens.