Lamivudine and high-dose interferon-alpha combination therapy for naive children with chronic hepatitis B infection.

Background: More than half of the children with chronic hepatitis B infection are nonresponders to interferon-a. The aim of this study was to investigate the efficacy of lamivudine and interferon-a combination therapy after a 3-month lamivudine induction in children with chronic hepatitis B. Study: Twenty naive children were given lamivudine (4 mg/kg per day; maximum, 100 mg) alone for 3 months; then interferon-a (10 MU/m 2 , thrice weekly) was added to lamivudine for 6 months. After interferon-a was stopped, lamivudine alone was continued for 6 months. Therapy was stopped 6 months after HBeAg seroconversion. Every 3 months, HBV markers were studied and virologic response was defined as HBV DNA negativity, and HBeAg loss with AntiHBe seroconversion. Results: At the end of 15 months, virologic response was achieved in 11 (55%) of patients and 12 patients (60%) cleared hepatitis B e antigen. Therapy was well tolerated. Conclusion: Preliminary results of our study seem to indicate that lamivudine and high-dose interferon-a combination therapy after a 3-month lamivudine induction may represent an effective treatment option for children with chronic hepatitis B.