Effect of interferon alfa and ribavirin treatment on hepatitis C virus RNA in serum and peripheral blood mononuclear cells in children with chronic hepatitis C

The correlations between the severity of hepatic lesions, age, gen- der, HBV co-infection and negativisation of HCV-RNA from serum and peripheral blood mononuclear cells (PBMC) after treatment of chronic hepatitis C (CHC) were analysed. 41 children (11 F/ 30 M), aged 5-16 years (mean 10 ± 2.8), were treated with IFN-a and rib- avirin for 12 months. Sustained negativisation of HCV-RNA from serum was achieved in 25 patients (61%), in 3 (7%) it reappeared after treatment, and in 13 (32%) it was ineffective. Clearance of HCV did not correlate with age (p = 0.65), sex (p = 0.13), past HBV infection (n = 22 anti-HBc +) (p = 0.24), maximum pre-treatment ALT activity (p = 0.06), grade of inflammation (p = 0.33) or stage of fibrosis (p = 0.9) in liver biopsy. It was achieved in 6/16 children previously resistant to IFN-a monotherapy and in 19/25 naïve (p = 0.017). HCV-RNA was detected in PBMC in 9/24 (37%) seronega- tive children and in 1/21 (5%) in comparative group of seronegative adults ; p = 0.004. Persistence of HCV-RNA in PBMC after com- bined treatment occurred in 5/10 (50%) patients resistant to previ- ous IFN-a monotherapy, 6/35 (20%) of them cleared HCV from PBMC (p = 0.04). Conclusions : Age and gender, infection route, history of HBV infection or severity of histopathologic liver lesions had no influence on the efficacy of treatment with IFN-a and rib- avirin. Clearance of HCV from serum and from PBMC occurs less frequently in patients previously resistant to IFN-a. Children with CHC require longitudinal observation after successful antiviral treatment as in 37% of those considered to be free from the virus by ordinary measures, HCV-RNA was found in PBMC. (Acta gastroenterol. belg., 2006, 69, 187-190).