About Us

Executive Editor:
Publishing house "Academy of Natural History"

Editorial Board:
Asgarov S. (Azerbaijan), Alakbarov M. (Azerbaijan), Aliev Z. (Azerbaijan), Babayev N. (Uzbekistan), Chiladze G. (Georgia), Datskovsky I. (Israel), Garbuz I. (Moldova), Gleizer S. (Germany), Ershina A. (Kazakhstan), Kobzev D. (Switzerland), Kohl O. (Germany), Ktshanyan M. (Armenia), Lande D. (Ukraine), Ledvanov M. (Russia), Makats V. (Ukraine), Miletic L. (Serbia), Moskovkin V. (Ukraine), Murzagaliyeva A. (Kazakhstan), Novikov A. (Ukraine), Rahimov R. (Uzbekistan), Romanchuk A. (Ukraine), Shamshiev B. (Kyrgyzstan), Usheva M. (Bulgaria), Vasileva M. (Bulgar).

Additional Information

Authors

Login to Personal account

Home / Issues / № 2, 2013

Materials of the conference "EDUCATION AND SCIENCE WITHOUT BORDERS"

Experience in the combination antiviral therapy treatment of children with chronic hepatitis C
Kuttykuzhanova G.G., E.E. Mukhaliev

Antiviral therapy of children with chronic viral hepatitis C (CVH C) remains to be an urgent issue, although we have already accumulated experience in treating children with Pegintron in combination with ribavirin since the year 2005. Results obtained by different authors are controversial, and the efficiency ranged from 41% to 80%. We have encountered especially great difficulties in the treatment of children with blood cancer on the background, as it is also mentioned by other authors.

The work objective was to evaluate the results of Pegintron and ribavirin treatment of children with chronic viral hepatitis C, and also to assess tolerability and safety of these medicinal products.

Material and methods.

44 children with chronic viral hepatitis C have undergone treatment from May 2011 to May 2012. 32 of them had concomitant disease - acute leukemia in remission. Age of children: 3-18 years (mean value - 10.4 years). Boys dominated by quantity (69%). The predominant route of infection is horizontal - 60%. 32 children had genotype 1, the others had genotype 2 and 3. 39 patients had normal transaminase levels, the remaining had increased transaminase level. Low baseline viral load was recorded in 30 patients, and high one, respectively, in 14 patients. Pegintron was administered at a dose of 60 mg / square meter of body surface area subcutaneously once a week, and ribavirin - 15 mg / kg per day daily. Duration of treatment depended on the virus genotype and the viral load. In case of genotype 1 the treatment duration was up to 48 weeks, in case of genotype 2 and 3 there was an opportunity to decrease treatment duration to 24 weeks.

Results: 3 of the 44 patients had to stop antiviral therapy, 2 of them due to recurrence of leukemia, and 1 of them because of the side effects of medicinal products. 2 children had mixed hepatitis B and C. At the end of treatment the total virological response (TVR) ​​was observed on average in 71% of all patients, but the results were different depending on the genotype of the virus and the presence of leukemia. Thus, chronic viral hepatitis C therapy effectiveness in patients with concomitant leukemia was 59%, and in patients without concomitant leukemia the value was 83%. Depending on the virus genotype, the TVR value in a group of children with genotype 1 was 68%, and in the group of children with genotypes 2 and 3 it occurred in 10 of 12 treated patients. Of these two non-responders had a combination of chronic viral hepatitis with acute leukemia, and the second one on the background of EVR (early virological response) had an exacerbation after the end of treatment (24 weeks) in the period of the first three months. In case of mixed hepatitis B and C the TVR was only for HCV. Besides virus genotype also baseline viral load influenced the results. Thus, at a high viral load (HVL) the stable virologic response (SVR) was achieved in 25% of cases, and at low viral load (LVL) SVR was achieved in 93% of cases. Baseline ALT levels did not affect the outcomes of treatment. Pegintron and ribavirin drug tolerance was good in general. Expected side effects were observed.

Conclusion: Thus, the results of treatment of children with chronic viral hepatitis C allow the appointment of Pegintron and ribavirin combination therapy. Furthermore, this treatment is possible also in case of concomitant acute leukemia, but only in its remission stage. Drug tolerance was good enough. In some cases with hepatitis of genotypes 2 and 3 there is a necessary to prolong treatment duration for more than 24 weeks, after reviewing all the predictors.



Bibliographic reference

Kuttykuzhanova G.G., E.E. Mukhaliev Experience in the combination antiviral therapy treatment of children with chronic hepatitis C . International Journal Of Applied And Fundamental Research. – 2013. – № 2 –
URL: www.science-sd.com/455-24299 (28.03.2024).