Combo Hepatitis C Treatment May Work in Kids
Study Shows More Than Half of Treated Children Have No Signs of Infection
All of the children with a form of the infection that is considered easiest to treat -- types 2 or 3 -- showed lasting evidence of being free of infection. Just under half of those with a harder-to-treat form of infection -- type 1 -- responded to the combination therapy.
Most of the children experienced mild flu-like symptoms during the first weeks of treatment. Other less commonly reported treatment side effects included weight loss and weakened immunity due to declines in white blood cell counts. One young girl also developed treatment-related diabetes.
"Children actually seem to tolerate this treatment better than adults do," study researcher Stefan Wirth, MD, tells WebMD. "It is clear that you should not ignore this infection in children. They should be offered treatment."
But Schwarz says it is not so clear if the combination approach is the best treatment for children with chronic hepatitis C infection. She says children and adolescents tend to respond well to pegylated interferon alone and the addition of ribavirin may be not only unnecessary but also unsafe. Its use has been associated with birth defects.
"We estimate that there are about 150,000 children and adolescents with hepatitis C in the United States, and many are probably sexually active teenage females," she says. "For this reason, we think it is very important to find out if ribavirin is really needed."
Schwarz is now recruiting children with hepatitis C between the ages of 5 and 18 for a study comparing treatment with pegylated interferon alone to combination treatment with pegylated interferon and ribavirin. She hopes to have findings from the study by the fall of 2006.
"The long-term risks of hepatitis C infection in children aren't well understood, but we do know that these children are at risk," she says. "There are case reports of children with hepatitis-C- related cirrhosis and children who need liver transplants because of infection."