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Does genotype predict response to treatment in children infected with hepatitis B perinatally?
Author(s) -
Boxall Elizabeth,
Sira Jaswant,
Kaskar Shamima,
Workman Judith,
Kelly Deirdre
Publication year - 2012
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23308
Subject(s) - genotype , adefovir , medicine , virology , lamivudine , seroconversion , hbeag , hepatitis b , immunology , hepatitis b virus , biology , gastroenterology , hbsag , genetics , virus , gene
HBV genotype may correlate with outcome and treatment response. Genotype has been compared with treatment response in children infected perinatally with hepatitis B following treatment with oral antiviral drugs (lamivudine or adefovir) or interferon (IFN) alone and with prednisolone priming (Pred/IFN). All children who took part in clinical trials in this unit since 1990 were included. Hepatitis B genotypes were determined by direct sequencing or using a commercial line probe assay (InnoLipa). Sixty‐five children were included; 20 were treated with IFN; 19 with Pred/IFN; 22 with lamivudine and 7 with adefovir, some took part in more than one treatment study. 63 out of 65 children were clearly typed into single genotypes; 16, 7, 3, and 37 typing as A, B, C, and D respectively. The majority of South‐Asian children had genotype D and European and Afro‐Caribbean children were more likely to have genotype A. Treatment response (seroconversion from HBeAg to Anti‐HBe) was better in children with genotypes A [n = 16] and D [n = 37] (55.5% and 48.7%), compared to those with B [n = 7] and C [n = 3] (12.5% and 0%) for all treatments. The response to interferon alone was better in children with genotype A compared to D (50% and 36%), but prednisolone priming improved the response so that there was no difference between genotypes A and D (66.7% and 70%). Assessment of genotype in children pre‐treatment may provide a guide to potential response. The response to treatment by genotype should be evaluated in future clinical trials in children. J. Med. Virol. 84:1535–1540, 2012. © 2012 Wiley Periodicals, Inc.