<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ppharm</journal-id><journal-title-group><journal-title xml:lang="ru">Педиатрическая фармакология</journal-title><trans-title-group xml:lang="en"><trans-title>Pediatric pharmacology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1727-5776</issn><issn pub-type="epub">2500-3089</issn><publisher><publisher-name>Издательство «ПедиатрЪ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15690/pf.v11i2.960</article-id><article-id custom-type="elpub" pub-id-type="custom">ppharm-122</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>В ПРАКТИКУ ПЕДИАТРА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>For Pediatricians' Practice</subject></subj-group></article-categories><title-group><article-title>ПЕРСОНАЛИЗИРОВАННЫЙ ПОДХОД К ЛЕЧЕНИЮ ХРОНИЧЕСКОГО ГЕПАТИТА С У ДЕТЕЙ</article-title><trans-title-group xml:lang="en"><trans-title>PERSONALIZED APPROACH TO TREATING CHRONIC HEPATITIS C IN CHILDREN</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скворцова</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Skvortsova</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>аспирант гастроэнтерологического отделения с гепатологической группой Научного центра здоровья детей</p></bio><bio xml:lang="en"><p>postgraduate of the gastroenterology department with a hepatology group of the Scientific Center of Children’s Health</p></bio><email xlink:type="simple">skvortcova.tamara@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Волынец</surname><given-names>Г. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Volynets</surname><given-names>G. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семикина</surname><given-names>Е. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Semikina</surname><given-names>E. L.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научный центр здоровья детей, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Center of Children’s Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научный центр здоровья детей, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Center of Children’s Health, Moscow, Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>04</day><month>04</month><year>2014</year></pub-date><volume>11</volume><issue>2</issue><issue-title>Педиатрическая фармакология</issue-title><fpage>66</fpage><lpage>71</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Скворцова Т.А., Волынец Г.В., Семикина Е.Л., 2014</copyright-statement><copyright-year>2014</copyright-year><copyright-holder xml:lang="ru">Скворцова Т.А., Волынец Г.В., Семикина Е.Л.</copyright-holder><copyright-holder xml:lang="en">Skvortsova T.A., Volynets G.V., Semikina E.L.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.pedpharma.ru/jour/article/view/122">https://www.pedpharma.ru/jour/article/view/122</self-uri><abstract/><trans-abstract xml:lang="en"><p>Predictors of positive virological response to interferon therapy in children have not been established, which is why it is necessary to identify them and subsequently develop individualized treatment regimens yielding the best possible results. Objective: form personalized chronic hepatitis C treatment regimens in children on the basis of identification of virological response predictors and retrospective evaluation of the conducted interferon therapy efficiency. Study participants: 98 children of 3-18 years of age (mean age – 10.0±0.8 years) with chronic hepatitis C: 65 of them had HCV 1 genotype (66.0%), 33 – HCV 2-3 genotype (34.0%). We measured anthropometric parameters (weight, height), determined viral load level in blood serum (polymerase chain reaction (PCR)), performed HCV genotyping (before the therapy) and analyzed lymphocytic immunophenotype parameters of all children before the interferon therapy course and over time (4, 12, 24 and 48 weeks after the therapy initiation). Results: Analysis of the obtained results demonstrated that the recombinant IFNα-2a therapy efficiency improves if recombinant IL2 (roncoleukin) is added to the treatment regimen: double increase in the rate of achievement of the primary virological remission (PVR) and sustained virological response (SVR) (p &lt; 0.05). Use of a pegylated IFNα-2b in combination with ribavirin did not yield any significant difference in comparison with treatment with recombinant IFNα-2a and recombinant IL2. Interferon therapy is more effective in children of at least 30 kg of body weight and 134 cm of height without physical developmental delay than in younger children (of smaller weight and height) at the moment of interferon therapy initiation (p &lt; 0.001). Thus, anthropometric parameters of patients may serve as PVR predictors regardless of the HCV genotype at the treatment initiation. If lymphocytes ≥ 2,500/mcl, the PVR achievement rate is 85.0%; if lymphocytes ≤ 2,000/mcl – 5.0% (p = 0.000). If the total amount of lymphocytes is 2,000-2,500, the examination should be repeated 12 weeks after the therapy initiation: increase in the number of lymphocytes in comparison with the initial values by 10.0% or more is positive prognostic SVR predictor. Conclusions: It is necessary to take into consideration parametric data and the child’s age at the moment of therapy initiation in order to schedule the launch of interferon therapy and choose a therapy regimen for chronic viral hepatitis C in children. Total amount of blood lymphocytes, child’s body weight and height at the moment of treatment initiation are predictors of positive virological response to treatment.</p><p> </p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический вирусный гепатит С у детей</kwd><kwd>заболеваемость детского населения</kwd><kwd>интерферонотерапия</kwd><kwd>противовирусная терапия</kwd><kwd>предикторы положительного вирусологического ответа</kwd><kwd>первичная вирусологическая ремиссия</kwd><kwd>стойкий вирусологический ответ</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic viral hepatitis C in children</kwd><kwd>child morbidity</kwd><kwd>interferon therapy</kwd><kwd>antiviral therapy</kwd><kwd>positive virological response predictors</kwd><kwd>primary virological remission</kwd><kwd>sustained virological response</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bortolotti F. Chronic hepatitis C in children: natural history and prognosis. Recenti Prog Med. 2009 Feb; 100 (2): 97–102.</mixed-citation><mixed-citation xml:lang="en">Bortolotti F. Chronic hepatitis C in children: natural history and prognosis. Recenti Prog. Med. 2009 Feb; 100 (2): 97–102.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Mohan N., Gonzalez-Peralta R. P., Fujisawa T., Chang M. H., Heller S., Jara P., Kelly D., Mieli-Vergani G., Shah U., Murray K. F. Chronic hepatitis C virus infection in children. J Pediatr Gastroenterol Nutr. 2010; 50: 123–131.</mixed-citation><mixed-citation xml:lang="en">Mohan N., Gonzalez-Peralta R. P., Fujisawa T., Chang M. H., Heller S., Jara P., Kelly D., Mieli-Vergani G., Shah U., Murray K. F. Chronic hepatitis C virus infection in children. J Pediatr Gastroenterol Nutr. 2010; 50: 123–131.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Ghany M. G., Strader D. B., Thomas D. L., Seeff L. B. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009; 49: 1335–1374.</mixed-citation><mixed-citation xml:lang="en">Ghany M. G., Strader D. B., Thomas D. L., Seeff L. B. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009; 49: 1335–1374.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Bortolotti F., Iorio R., Resti M., Camma C., Marcellini M., Giacchino R., Marazzi M. G., Verucchi G., Zancan L., Barbera C., Maggiore G., Vajro P., Giannattasio A., Bartolacci S. Italian Observatory for HCV Infection and Hepatitis C in Children. Epidemiological profile of 806 Italian children with hepatitis C virus infection over a 15-year period. J Hepatol. 2007 Aug; 47 (2): 311.</mixed-citation><mixed-citation xml:lang="en">Bortolotti F., Iorio R., Resti M., Camma C., Marcellini M., Giacchino R., Marazzi M. G., Verucchi G., Zancan L., Barbera C., Maggiore G., Vajro P., Giannattasio A., Bartolacci S. Italian Observatory for HCV Infection and Hepatitis C in Children. Epidemiological profile of 806 Italian children with hepatitis C virus infection over a 15-year period. J. Hepatol. 2007 Aug; 47 (2): 311.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Bortolotti F., Resti M., Marcellini M., Giacchino R., Verucchi G., Nebbia G., Zancan L., Marazzi M. G., Barbera C., Maccabruni A., Zuin G., Maggiore G., Balli F., Vajro P., Lepore L., Molesini M., Guido M., Bartolacci S., Noventa F. Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome. Gut. 2005 Jun; 54 (6): 852–7.</mixed-citation><mixed-citation xml:lang="en">Bortolotti F., Resti M., Marcellini M., Giacchino R., Verucchi G., Nebbia G., Zancan L., Marazzi M. G., Barbera C., Maccabruni A., Zuin G., Maggiore G., Balli F., Vajro P., Lepore L., Molesini M., Guido M., Bartolacci S., Noventa F. Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome. Gut. 2005 Jun; 54 (6): 852–857.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Bortolotti F., Iorio R., Nebbia G., Marcellini M., Giacchino R., Zancan L., Gussetti N., Barbera C., Maccabruni A., Verucchi G., Balli F., Vegnente A., Guido M., Bartolacci S. Interferon treatment in children with chronic hepatitis C: long-lasting remission in responders, and risk for disease progression in non-responders. Dig Liver Dis. 2005 May; 37 (5): 336–41.</mixed-citation><mixed-citation xml:lang="en">Bortolotti F., Iorio R., Nebbia G., Marcellini M., Giacchino R., Zancan L., Gussetti N., Barbera C., Maccabruni A., Verucchi G., Balli F., Vegnente A., Guido M., Bartolacci S. Interferon treatment in children with chronic hepatitis C: long-lasting remission in responders, and risk for disease progression in non-responders. Dig, Liver Dis. 2005 May; 37 (5): 336–341.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Guido M., Bortolotti F. Viral hepatitis: Treating hepatitis C in children: an open horizon. Nat Rev Gastroenterol Hepatol. 2011 May; 8 (5): 247–8.</mixed-citation><mixed-citation xml:lang="en">Guido M., Bortolotti F. Viral hepatitis: Treating hepatitis C in children: an open horizon. Nat. Rev. Gastroenterol. Hepatol. 2011 May; 8 (5): 247–8.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Волынец Г. В., Потапов А. С., Пахомовская Н. Л. Повышение эффективности интерферонотерапии хронического гепатита С у детей с помощью рекомбинантного интерлейкина-2 (Ронколейкин). Российский педиатрический журнал. 2011; 6: 9–13.</mixed-citation><mixed-citation xml:lang="en">Volynets G.V., Potapov A.S., Pakhomovskaya N.L. Rossiiskii pediatricheskii zhurnal = Russian pediatric journal. 2011; 6: 9–13.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Потапов А. С., Пахомовская Н. Л., Волынец Г. В., Четкина Т. С. Интерферонотерапия хронического вирусного гепатита С у детей. Фарматека. 2009; 13: 67–71.</mixed-citation><mixed-citation xml:lang="en">Potapov A.S., Pakhomovskaya N.L., Volynets G.V., Chetkina T.S. Farmateka = Pharmateca. 2009; 13: 67–71.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Волынец Г. В., Потапов А. С., Пахомовская Н. Л., Цимбалова Е. Г., Сурков А. Н., Полякова С. И., Четкина Т. С. Способ повышения эффективности интерферонотерапии хронического гепатита С у детей. Патент на изобретение RUS 2468815 08.08.2011.</mixed-citation><mixed-citation xml:lang="en">Volynets G.V., Potapov A.S., Pakhomovskaya N.L., Tsimbalova E.G., Surkov A.N., Polyakova S.I., Chetkina T.S. Sposob povysheniya effektivnosti interferonoterapii khronicheskogo gepatita S u detei. Patent na izobretenie RUS 2468815 08.08.2011 [Method of Increasing Interferon Therapy Efficacy for Chronic Hepatitis C in Children. Patent for invention RUS 2468815 of 08.08.2011].</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Потапов А. С., Пахомовская Н. Л., Волынец Г. В. Эффек тив ность противовирусной терапии хронического вирусного гепатита С у детей. Вопросы современной педиатрии. 2009; 8 (6): 101–105.</mixed-citation><mixed-citation xml:lang="en">Potapov A.S., Pakhomovskaya N.L., Volynets G.V. Voprosy sovremennoi pediatrii = Current pediatrics. 2009; 8(6): 101–105.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Wirth S., Ribes-Koninckx C., Calzado M. A., Bortolotti F., Zancan L., Jara P., Shelton M., Kerkar N., Galoppo M., Pedreira A., Rodriguez-Baez N., Ciocca M., Lachaux A., Lacaille F., Lang T., Kullmer U., Huber W. D., Gonzalez T., Pollack H., Alonso E., Broue P., Ramakrishna J., Neigut D., Valle-Segarra A. D., Hunter B., Goodman Z., Xu C. R., Zheng H., Noviello S., Sniukiene V., Brass C., Albrecht J. K. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin. J Hepatol. 2010 Apr; 52 (4): 501–7.</mixed-citation><mixed-citation xml:lang="en">Wirth S., Ribes-Koninckx C., Calzado M. A., Bortolotti F., Zancan L., Jara P., Shelton M., Kerkar N., Galoppo M., Pedreira A., Rodriguez-Baez N., Ciocca M., Lachaux A., Lacaille F., Lang T., Kullmer U., Huber W. D., Gonzalez T., Pollack H., Alonso E., Broue P., Ramakrishna J., Neigut D., Valle-Segarra A. D., Hunter B., Goodman Z., Xu C. R., Zheng H., Noviello S., Sniukiene V., Brass C., Albrecht J. K. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin. J. Hepatol. 2010 Apr; 52 (4): 501–7.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Bortolotti F., Indolfi G., Zancan L., Giacchino R., Verucchi G., Cam ma C., Barbera C., Resti M., Marazzi M. G., Guido M. Management of chronic hepatitis C in childhood: the impact of therapy in the clinical practice during the first 2 decades. Dig Liver Dis. 2011 Apr; 43 (4): 325–9.</mixed-citation><mixed-citation xml:lang="en">Bortolotti F., Indolfi G., Zancan L., Giacchino R., Verucchi G., Cam ma C., Barbera C., Resti M., Marazzi M. G., Guido M. Management of chronic hepatitis C in childhood: the impact of therapy in the clinical practice during the first 2 decades. Dig. Liver Dis. 2011 Apr; 43 (4): 325–9.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Волынец Г. В., Потапов А. С., Пахомовская Н. Л., Цимбалова Е. Г., Скворцова Т. А., Семикина Е. Л. Способ прогнозирования эффективности интерферонотерапии хронических гепатитов С у детей. Патент на изобретение RUS 2486526 15.05.2012.</mixed-citation><mixed-citation xml:lang="en">Volynets G.V., Potapov A.S., Pakhomovskaya N.L., Tsimbalova E.G., Skvortsova T.A., Semikina E.L. Sposob prognozirovaniya effektivnosti interferonoterapii khronicheskikh gepatitov S u detei. Patent na izobretenie RUS 2486526 15.05.2012 [Method of Prognosing Interferon Therapy Efficacy for Chronic Hepatitis C in Children. Patent for invention RUS 2486526 of 15.05.2012].</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Лопаткина Т. Н. Индивидуализированная противовирусная терапия хронического вирусного гепатита С сегодня. Гепатологический форум. Приложение к журналу «Клиническая фармакология и терапия». 2011; 4: 15–20.</mixed-citation><mixed-citation xml:lang="en">Lopatkina T.N. Gepatologicheskii forum. Prilozhenie k zhurnalu «Klinicheskaya farmakologiya i terapiya» - Hepatological forum. Supplement to journal “Clinical pharmacology and therapy”. 2011; 4: 15–20.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. Journal of Hepatology. 2011. Европейская ассоциации по изучению печени (European Association for the Study of the Liver, EASL).</mixed-citation><mixed-citation xml:lang="en">EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. Journal of Hepatology. 2011. (European Association for the Study of the Liver, EASL).</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
