Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

The study was performed on 66 pediatric patients (3-18 years of age), of both sexes, infected with HCV GT4. Children were treated with PEG IFN Ü 2b in a dose of 60 æg/m2, given as subcutaneous injection once weekly and RBV in a dose of 15 mg/kg in 2 divided doses orally, daily. Treatment outcome was assessed by the absence of detectable viral RNA in blood 24 weeks after end of treatment, i.e., sustained virological response (SVR). Safety was assessed by performing specific investigations, weight and height measurements and questionnaires directed to the patients at specific intervals. Results: Forty three out of the 66 included patients (65.2%) were males. Mean age of the patients at the time of enrollment in the study was 10.9 + 3.5 years. SVR was achieved in 28 patients (42.4%). Comparing the group of responders to the non responders, history of treated malignancies was significantly commoner in non responders group (P= 0.03), responders had significantly higher levels of absolute neutrophilic count and lower levels of GGT (P= 0.009 and 0.003 respectively). HCV PCR level was significantly lower in responders (P=0.03). Fever was the most frequently reported side effect occurring in 98.5% of the patients followed by musculoskeletal symptoms. Neutropenia was observed in 36 patients (54.6%) which necessitated treatment discontinuation in only one patient. Seventy percent of children, who received the combined therapy for a total of 48 weeks, showed a drop in both weight and height percentiles at the end of the 48 weeks. Conclusion: The currently available treatment, PEG-IFNÜ 2b and RBV, for HCV GT 4 in pediatric patients has modest SVR of 42.4% with numerous adverse events necessitating meticulous monitoring to optimize care of the patients. Side effects could be managed with dose modifications and specific treatment when necessary

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