In our Pediatric Haemato-Oncology Unit, 42 young patients cured of their
malignancy were left with
chronic delta hepatitis. The severity of
liver disease in many of these patients prompted us to start a pilot study on the effect of recombinant alpha 2b
interferon, given at a dose of 5 MU/square meter thrice weekly. All nine patients included in the study (five males, mean age: 15 years) had well-compensated
liver disease, including five cases with active
hepatitis and
cirrhosis. At the end of the 3rd month of
therapy, two patients with
cirrhosis developed a biochemical exacerbation leading to hepatic decompensation, which was fatal in one case. The reasons for this unfavourable outcome remain unclear. Basic immunological tests were normal, but one of the two patients was the single case with anti-liver-kidney microsome
antibodies. On the other hand, both patients seroconverted from
hepatitis B e antigen to antibody at the time of exacerbation, suggesting that liver damage could have been the result of cell-mediated cytotoxicity to hepatitis B virus
antigens. The results of this study, which has been interrupted at the 4th month, suggest that
interferon therapy for
chronic delta hepatitis has to be considered cautiously in young patients cured of pediatric
malignancies. In fact, no beneficial effect was seen and the treatment appeared to be harmful in at least two out of nine patients treated.