Article Text


Viral hepatitis
PMO-155 Low pre-treatment HBsAG plasma levels, on therapy HBsAG levels decline and IP-10 concentrations increase predict response to treatment in tolerant children with chronic hepatitis B
  1. I Carey,
  2. M J Bruce,
  3. M Hussain,
  4. M Horner,
  5. S Bansal,
  6. D Vergani,
  7. G Mieli-Vergani
  1. Institute of Liver Studies and Transplantation, King's College Hospital, London, UK


Introduction Changes in HBsAg plasma levels during antiviral therapy with pegylated interferon (IFN) predict response in chronic hepatitis B (CH-B). High baseline plasma levels of inducible interferon-γ protein 10 (IP-10) predicted HBsAg loss in CH-B adults patients on nucles(t)ide analogues (NA) therapy. No data are available on the relationship between IP-10 and HBsAg plasma levels in children with infancy-acquired CH-B on combination therapy.

Aims To investigate whether baseline plasma IP-10 levels and their changes during therapy can help to predict HBsAg loss in children with infancy-acquired CH-B on combination therapy with lamivudine (LAM) and IFN-α.

Methods Patients: 23 children (eight males, median age 10.2 yrs) with infancy-acquired CH-B (all HBeAg+), treated for 52 weeks [lead-in LAM (3 mg/kg/d) for 9 weeks; LAM plus IFN-α (5 MU/m2 TIW) from week 9 for 44 weeks], were divided according to treatment response: five responders (R = anti-HBs seroconversion) and 18 non-responders (NR).

Methods Plasma IP-10, HBsAg and AST levels were measured in serial samples before (treatment week 0, TW0), during (TW9, TW28, TW52) and after (follow-up week, FUW24) therapy by ELISA [pg/ml], Abbott ARCHITECT® assay [log10 IU/ml] and AutoAnalyser [IU/l]. The results are presented median.

Results Baseline IP-10 levels were similar in R and NR (123 vs 99, p=0.4), but increased significantly in R than NR at TW28 (220 vs 79, p=0.04). Baseline HBsAg levels were lower in R than NR (4.36 vs 4.74, p=0.02), but similar in R and NR at TW9 (4.34 vs 4.66, p=0.1) and markedly lower in R than NR during IFN add-on therapy and therapy follow-up (TW28: 2.34 vs 4.33; TW52: 0 vs 4.08 and FUW24: 0 vs 4.51; p<0.01 for all). Baseline AST levels were similar in R and NR (29 vs 31, p=0.6) and tended to be higher in R than NR at TW28 (47 vs 32, p=0.07). At TW28, there was an inverse correlation between IP-10 and HBsAg levels (r=−0.45, p=0.03), but no correlation with AST.

Conclusion Low baseline HBsAg levels, HBsAg plasma levels decline and IP-10 concentrations increase during interferon add-on at TW28 predict HBsAg loss and response to therapy in tolerant children with CH-B.

Competing interests I Carey grant/research support from: BMS, Gilead, M Bruce: None declared, M Hussain: None declared, M Horner: None declared, S Bansal: None declared, D Vergani: None declared, G Mieli-Vergani: None declared.

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