PREDICTORS VIROLOGIC RESPONSE GOOD AS THE BASIS OF SELECTION INDIVIDUALIZED THERAPY FOR CHRONIC HEPATITIS C IN CHILDREN

Objective. Establish positive predictors of virologic response to interferon in children with chronic hepatitis C on the basis of a comprehensive evaluation of clinical and diagnostic procedures to justify the selection of individualized therapy. Study participants. 148 children of 3-17 years of age (mean age - 9.2 ± 0.3 years) with chronic hepatitis C: 97 (65.5%) of them had HCV 1 genotype, 51 (34.5%) - HCV 2-3 genotype. We measured anthropometric parameters (weight, height), determined viral load level in blood serum PCR and analyzed lymphocytic immunophenotype parameters, serum interferon induced synthesis of alpha and gamma interferon of all children before the interferon therapy course and over time (4, 12, 24 and 48 weeks after the therapy initiation). Results. Efficiency of treatment with recombinant interferon alfa-2a (rIFN-2a) and recombinant interleukin-2 (rIL-2) is increased when included in the treatment regimen rIL-2, the percentage of a primary virological remission (PVR) increased by 2 times. In the treatment of pegylated interferon alfa-2b and ribavirin positive predictors of virologic response is the child’s age of >6 years, weight >23 kg, height >115 cm, serum interferon 16-22 U/ml and the level of the absolute number of neutrophils 2000-3400/mkl, levels in the absolute number of blood lymphocytes 2500/mkl or more at the start of therapy. In the treatment of rIFN-2a and rIL-2 levels are predictive of the absolute number of lymphocytes 2500/mkl or more, and lymphocyte CD16+56+ 540/mkl or more at the start of treatment. Given the identified positive predictors of virologic response algorithm selecting individualized therapy for children with CHC. Conclusions. Individualized treatment decisions for children with chronic hepatitis C, taking into account the identified positive predictors of virologic response can increase the effectiveness of treatment to 83.0%.

chronic viral hepatitis C, children, interferon therapy, weight, height, positive virological response predictors, primary virological remission, sustained virological response

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