[An open-label pilot study evaluating the efficacy and safety of peginterferon alfa-2a combined with ribavirin in children with chronic hepatitis C].

OBJECTIVE: To evaluate the efficacy and safety of peginterferon alfa-2a plus ribavirin in the treatment of children with chronic hepatitis C (CHC) in China. METHODS: Totally 54 children with CHC were treated with peginterferon alfa-2a plus ribavirin from July 2003 to July 2004. The dose of peginterferon alfa-2a was 104 microg.(m2)-1 per week. An inductive treatment with interferon 1-3 MIU q.o.d for a week was given before peginterferon for the reduction of possible side effects. Initially 1/3 to 1/2 dose of ribavirin was given and then the was gradually increased to an ideal level of 15-20 mg.kg(-1).d(-1). RESULTS: The mean age of the patients was 11.3 years. Twenty three patients (42.6%) had received interferon plus ribavirin but the disease relapsed or did not respond to the treatment. The HCV of 70.8 percent of patients was genotype 1 and 14.8 percent of patients had a high viral load (>/=10(-6)/L). After 3-month treatment, 87.5% (42/48) and 8.3% (4/48) of the patients became HCV RNA negative or the viral load reduced by >/= 2 log, respectively, and only 8.3% (4/48) of the patients failed to respond. After 6-month treatment, 87.9% (29/33) and 6.1% (2/33) of the patients became HCV RNA negative or had a >/= 2 log reduction of HCV RNA, respectively, and only 6.1% (2/33) failed to respond. The adverse events were the typical of those reported in the treatment with interferon and ribavirin. Pyrexia occurred in 48.1% of patients, fatigue in 46.3%, decreased appetite in 9.3%, and skin rash in 3.7%. The absolute neutrophil counts of 51 patients (94.4%) were reduced to </= 2.0 x 10(-9)/L, and in 35.2% of them to < 1.0 x 10(-9)/L. Hemoglobin were reduced in only 2 patients (in one case to < 100 g/L, and in the other to < 110 g/L). CONCLUSION: The regimen consisted of peginterferon alfa-2a and ribavirin achieved a high virologic response in Chinese children patients with chronic hepatitis C. No severe adverse events occurred and most of the patients well tolerated the treatment.