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Treatment of children with chronic hepatitis B using recombinant alpha-interferon during three months
302
TREATMENT OF C H I L D R E N WITH CHRONIC HEPATITIS B USING RECOMBINANT ALPHA-INTERFERON DURING THREE MONTHS. F.La Banda, J.Jim4nez, J.C.Porres, M.Ruiz, J.Bartolom4, I.Mora, V.Carre~o. Department of G a s t r o e n t e r o l o g y , Fundacidn Jim4nez Diaz, madrid, SPAIN.
Hepatitis B virus (HBV) c h r o n i c infection in c h i l d h o o d is n o r m a l l y associated to a h i g h d e g r e e of v i r a l r e p l i c a t i o n and liver damage. A controlled s t u d y of r e c o m b i n a n t leukocyte A interferon (rIFN-~ , Roferon) in 24 c h i l d r e n (2-12 y e a r s ) h a s b e e n p e r f o r m e d . Patients were randomly al~ocated in 2 g r o u p s : Control (n=12) a n d t r e a t m e n t (n=12) , w h o r e c e i v e d i0 M U / m - b o d y surface, I.M., thrice weekly during 3 months. A l l of t h e m h a d an h i s t o l o g i c a l diagnosis of C H A a n d w e r e H B s A g , H B e A g a n d H B V - D N A p o s i t i v e for at l e a s t 6 months before entry into the study. Recombinant-IFN therapy was well tolerated in c h i l d r e n a n d a l l of t h e m completed t h e c o u r s e of t r e a t m e n t . N o n e of the c h i l d r e n developed anti-rIFNantibodies d u r i n g t h e s t u d y . At t h e t h i r d m o n t h , 4 o u t of 12 (33%) t r e a t e d patients, became HBV-DNA negative and remained llke that until the sixth m o n t h of the s t u d y . In c o n t r a s t , n o n e of the c o n t r o l group lost HBV-DNA during t h a t t i m e , In a d d i t i o n , one treated patient lost HBeAg. A marked decrease in G P T l e v e l s , a m o n g t h e f o u r r e s p o n d e r children was observed. In c o n t r a s t , no v a r i a t i o n s among non-responders were detected. In c o n c l u s i o n , rIFN-~ therapy in C A H - H B V infection in c h i l d r e n is w e l l tolerated. In a d d i t i o n , an a n t i v i r a l effect was observed a n d it s e e m s to be permanent.
303
HBV DNA SEQUENCES IN SERA OF HBsAG NEGATIVE BLOOD DONORS WITH ABNORMAL SERUM TRANSAMINASE LEVELS M.E.Lai,P.FarcitA.FiKus,M.Arnone* and A.Balestrieri Department of Internal Medicine University of Cagliari and*Division of blood and blood products USL 21Cagliari
Blood donors with elevated serum transaminase levels are more likely to transmit NANB hepatitis to their recipients than are donors with normal transamlnase levels. Recent studies provide evidence that HBV related variants,immunologically distinct from HBV,may be implicated in trasmitting posttransfusion hepatitis. Sera from 412 HBsAg negative blood donors with abnormal serum transaminase levels, ranging from 53 to 436 UI, were tested for the presence of serum HBV DNA sequences by dotspot hybridization, using as a probe 32p nick-translated HBV entire genome, purified from pBR cloning vector by electrophoresis separative gel. HBV DNA hybridizable sequences were found in 61 (14.8%) out of 412 sera examined. Of 6 1 H B V DNA positive subjects, 15 (24.6%) were antiHBc serum positive while the remaining 46 (75.4%) were negative for all HBV serum markers. Our data provide further evidence that HBV DNA sequences,
related to or homologous with
HBV, may be detected in sera of HBsAg negative subjects. Cloning and sequencing experiments are in progress to define the properties of these elusive non A non B agents.
S157
TREATMENT OF C H I L D R E N WITH CHRONIC HEPATITIS B USING RECOMBINANT ALPHA-INTERFERON DURING THREE MONTHS. F.La Banda, J.Jim4nez, J.C.Porres, M.Ruiz, J.Bartolom4, I.Mora, V.Carre~o. Department of G a s t r o e n t e r o l o g y , Fundacidn Jim4nez Diaz, madrid, SPAIN.
Hepatitis B virus (HBV) c h r o n i c infection in c h i l d h o o d is n o r m a l l y associated to a h i g h d e g r e e of v i r a l r e p l i c a t i o n and liver damage. A controlled s t u d y of r e c o m b i n a n t leukocyte A interferon (rIFN-~ , Roferon) in 24 c h i l d r e n (2-12 y e a r s ) h a s b e e n p e r f o r m e d . Patients were randomly al~ocated in 2 g r o u p s : Control (n=12) a n d t r e a t m e n t (n=12) , w h o r e c e i v e d i0 M U / m - b o d y surface, I.M., thrice weekly during 3 months. A l l of t h e m h a d an h i s t o l o g i c a l diagnosis of C H A a n d w e r e H B s A g , H B e A g a n d H B V - D N A p o s i t i v e for at l e a s t 6 months before entry into the study. Recombinant-IFN therapy was well tolerated in c h i l d r e n a n d a l l of t h e m completed t h e c o u r s e of t r e a t m e n t . N o n e of the c h i l d r e n developed anti-rIFNantibodies d u r i n g t h e s t u d y . At t h e t h i r d m o n t h , 4 o u t of 12 (33%) t r e a t e d patients, became HBV-DNA negative and remained llke that until the sixth m o n t h of the s t u d y . In c o n t r a s t , n o n e of the c o n t r o l group lost HBV-DNA during t h a t t i m e , In a d d i t i o n , one treated patient lost HBeAg. A marked decrease in G P T l e v e l s , a m o n g t h e f o u r r e s p o n d e r children was observed. In c o n t r a s t , no v a r i a t i o n s among non-responders were detected. In c o n c l u s i o n , rIFN-~ therapy in C A H - H B V infection in c h i l d r e n is w e l l tolerated. In a d d i t i o n , an a n t i v i r a l effect was observed a n d it s e e m s to be permanent.
303
HBV DNA SEQUENCES IN SERA OF HBsAG NEGATIVE BLOOD DONORS WITH ABNORMAL SERUM TRANSAMINASE LEVELS M.E.Lai,P.FarcitA.FiKus,M.Arnone* and A.Balestrieri Department of Internal Medicine University of Cagliari and*Division of blood and blood products USL 21Cagliari
Blood donors with elevated serum transaminase levels are more likely to transmit NANB hepatitis to their recipients than are donors with normal transamlnase levels. Recent studies provide evidence that HBV related variants,immunologically distinct from HBV,may be implicated in trasmitting posttransfusion hepatitis. Sera from 412 HBsAg negative blood donors with abnormal serum transaminase levels, ranging from 53 to 436 UI, were tested for the presence of serum HBV DNA sequences by dotspot hybridization, using as a probe 32p nick-translated HBV entire genome, purified from pBR cloning vector by electrophoresis separative gel. HBV DNA hybridizable sequences were found in 61 (14.8%) out of 412 sera examined. Of 6 1 H B V DNA positive subjects, 15 (24.6%) were antiHBc serum positive while the remaining 46 (75.4%) were negative for all HBV serum markers. Our data provide further evidence that HBV DNA sequences,
related to or homologous with
HBV, may be detected in sera of HBsAg negative subjects. Cloning and sequencing experiments are in progress to define the properties of these elusive non A non B agents.
S157