Hepatitis C virus infection and interferon therapy in patients with Down syndrome

Abstract

IFN therapy for HCV infection in patients with DS may be unfavorable as compared with non-DS children.

Peginterferon alpha-2b and ribavirin for the treatment of chronic hepatitis C in Japanese pediatric and young adult patients: a survey of the Japan Society of Pediatric Hepatology

“…In addition, earlier studies have shown that two conditions were associated with nonresponsiveness to conventional interferon in pediatric patients; malignant disease and 21 trisomy [21,24]. This study shows that the therapy was similarly efficacious in pediatric and young adult patients with either of the two unfavorable factors as it was in those without them.…”

“…Pretreatment antinuclear antibodies or smooth muscle antibodies was negative and thyroid function was normal. Eighteen of the 37 patients, a part of these 18 patients having been reported previously, had failed to respond to monotherapy using natural interferon-a [20][21][22]. Institutional ethics committees at participating centers approved the protocols of the study.…”

Pegylated interferon for hepatitis C virus infection in Down syndrome

“…In 2008, Miyoshi et al first reported the efficacy of natural IFN-a for HCV patients with DS. 1 Out of six study patients (five patients with genotype 1 and one with genotype 2) who received natural IFN-a, none had clearance of HCV-RNA in their serum. At that time, the Japan Society of Pediatric Hepatology did not encourage the exclusive use of natural IFN-a for the treatment of chronic HCV infection in patients with DS.…”

“…At that time, the Japan Society of Pediatric Hepatology did not encourage the exclusive use of natural IFN-a for the treatment of chronic HCV infection in patients with DS. 1 In 2004, pegylated interferon (PEG-IFN)-a2a monotherapy for adult patients with chronic hepatitis C (CHC) was approved by the Japanese insurance system, following which PEG-IFN-a2b plus ribavirin (RBV) combination therapy was recommended in 2005. In 2012, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) created a pediatric HCV guideline working group, which first recommended that the duration of PEG-IFN/RBV combination therapy should be 48 weeks of treatment for genotypes 1 or 4 and 24 weeks for genotypes 2 or 3.…”

Direct Acting Antivirals in Patients with Chronic Hepatitis C and Down Syndrome

“…However, the majority of these patients do not manifest clear clinical features of immunological disorders. Despite these observations, limited experiences with interferon-based therapy in the setting of Down syndrome showed dismal results with none of the patients responding to treatment [5], raising the question whether immunological disturbances in patients with Down syndrome may result in poor performance of immune-dependent interferon therapy [4]. …”