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[Effects of treatment with pegylated interferon and ribavirin in children with chronic hepatitis C].

OBJECTIVE
The aim of his study is to evaluate the influence of the baseline ALT activity, HCV viral load and genotype on the effects of the treatment with pegylated interferon alpha 2 b and ribavirin in children with CHC.


METHODS
Twenty children with chronic hepatitis C were enrolled to the study. All were treated with pegylated interferon alpha and ribavirin for 48 weeks. Viral genotype, advancement of changes in histopathological examination and ALT activity with HCV-RNA viral load in respective periods of the treatment were analyzed.


MAIN OBSERVATIONS AND RESULTS
All children were infected with genotype 1. The advancement of inflammatory changes and fibrosis in the liver was mediocre. On the basis of the outcome of treatment in the 24th week of the treatment the study group was divided to group A n = 17, which eliminated HCV, and group B n = 3 without elimination. In some of the patients n = 10 viral response was assessed directly after the therapy. In 8 children HCV elimination was confirmed, however in 2 patients replication was still present. ALT activity decreased with the decline of the viral load.


CONCLUSIONS
During the treatment HCV RNA elimination occurs in 85% of children infected with genotype 1. ETR seem to achieve similar ratio. The influence of ALT activity, HCV viral load and the advancement of changes in histopathological examination on the HCV RNA elimination remains unclear. The adverse-effects are not significant and abnormalities in clinical chemistry do not cause permanent cease of the therapy.