P86 Does genotype predict response to treatment in children perinatally infected with hepatitis B virus

Introduction Hepatitis B Virus (HBV) genotype is now thought to correlate to outcome and response to treatment. Aim To compare viral genotype with treatment response in children infected perinatally with HBV, who had been treated with subcutaneous Interferon alpha2b (IFN) with or without Prednisolone priming (Pred/IFN), oral antiviral drugs (Lamivudine or Adefovir). Method All children who took part in the clinical trials in this unit since 1990 were included. The hepatitis B genotypes were determined using a commercial line probe assay (InnoLipa), which was validated against direct sequencing. Results 70 children were recruited to clinical trials, 68 of whom had genotype analysis. 5 children had more than one course of therapy: The genotype results correlated with the geographical origin of the families of the children. European and Afro-Caribbean children have genotype A, Oriental children only had genotype B, while the majority of South Asian children had genotype D. Genotype C was uncommon in any of these ethnic groups. Overall response to treatment was better in children with genotypes A 10/18 (55%) and D 19/39 (49%) compared to those with B and C for all forms of treatment. Although the response to Interferon alone was better in children with genotype A (50%) compared to D (36%), prednisolone priming improved the response in both genotypes to 67% & 70% respectively. Conclusion Pre-treatment assessment of genotype in children may provide a guide to potential response and improve information and choice for families.