Thyroid disturbances in children treated with combined pegylated interferon-alpha and ribavirin for chronic hepatitis C

Dynamic Changes of Growth and Thyroid Function in Young Children With Chronic Hepatitis B Treated With Peginterferon Monotherapy

BACKGROUND

Peginterferon (PegIFN) has shown promising results in the treatment of chronic hepatitis B (CHB). This study aimed to evaluate the effects of PegIFN α-2b on growth and thyroid function in young children with CHB.

METHODS

A retrospective study was performed by extracting clinical data from children with CHB who received PegIFN α-2b monotherapy at the Public Health Clinical Center of Chengdu between June 2017 and December 2020. Mean, SD, independent samples t test and 1-way repeated analysis of variance were used to evaluate relevant data.

RESULTS

A total of 62 children were included in this study. Overall, significant differences were observed in the weight-for-age z score (WAZ), height-for-age z score (HAZ) and body mass index-for-age z score (BAZ) at different time points ( P < 0.001). WAZ, HAZ and BAZ were not affected by PegIFN α-2b at 24 weeks of treatment (all P > 0.05). WAZ, HAZ and BAZ at the end of treatment and 48 weeks after treatment; WAZ at 96 weeks after treatment were lower than baseline levels (all P < 0.05). No statistical differences were found in HAZ and BAZ at 96 weeks after treatment compared with baseline. Thyroid dysfunction developed in 17.7% of children during the treatment. Thyroid dysfunction was transient and had no effect on growth.

CONCLUSIONS

PegIFN α-2b has inhibitory effects on growth and can increase the incidence of thyroid dysfunction in young children with CHB. These effects are generally reversible with the cessation of therapy, although WAZ had not returned to baseline after 96 weeks of observation.

Narrative review of pediatric thyroiditis: Diagnosis and management

OBJECTIVE

To the best of the authors' knowledge, no current literature reviews on pediatric thyroiditis exist. Our aim is to present relevant and updated information on pediatric thyroiditis subtypes and presentations.

DATA SOURCES

A narrative review was performed using PubMed and Embase.

REVIEW METHODS

A narrative literature review was performed to find articles in two databases: PubMed and Embase that discussed the various subtypes of thyroiditis in pediatric patients. Relevant key terms included: thyroiditis, pediatric, children, clinical findings, autoimmune thyroiditis, prevalence, and etiology.

DISCUSSION

112 articles were included in this review. The subtypes and clinical presentations of pediatric thyroiditis were highlighted to demonstrate that thyroid dysfunction can have unique wide-ranging effects compared to adult populations. Recommendations on diagnostic algorithms, management, and clinical consequences of delayed treatment are discussed.

CONCLUSIONS

Thyroid hormones are incredibly vital to the development of a child. It is important to identify and prevent long-term consequences clinically by implementing early treatment through awareness of these differences in clinical practice.

Management of Hepatitis C in Children and Adolescents

The management of hepatitis C virus (HCV) infections has changed dramatically in recent years with the use of direct antiviral agents (AADs). New AADs have excellent safety profile and demonstrated to be highly effective. Interferon free regimens are now recommended for children and adolescents but significant barriers for treatment exist. Overcoming those barriers will facilitate HCV elimination. This review covers varied topics to familiarize providers with the current status of pediatric HCV management in light of newly available DAAs medications.