The Efficacy and Safety of an Interferon Inducer as an Adjunct Treatment to Dengue Hemorrhagic Fever Among Pediatric Patients Admitted in a Tertiary Hospital

Background: Current therapy for the treatment of dengue is primarily supportive with emphasis on fluid management. Interferon inducer affinity purified antibodies to human interferon gamma is a drug containing release active antibodies to human interferon gamma, which has immunomodulatory and antiviral effects by inhibiting the replication of virus and stimulating the induction of endogenous interferon. Primary indication for the use of interferon inducers include therapy and prevention of upper respiratory tract and acute viral infections. Locally, no research has been done in utilizing interferon inducer as an adjunct therapy in dengue patients. The study aimed to assess the efficacy and safety of an interferon inducer as an adjunct treatment to dengue hemorrhagic fever among admitted pediatric patients.

Methods: It is an open labelled randomized controlled clinical trial. Admitted pediatric patients aged 6 months to 18 years old diagnosed with dengue with warning signs and dengue severe from January to February 2020 were randomized into two groups. Inability to tolerate oral medications, clinical evidence of significant respiratory, metabolic, cardiac, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric, or chronic disease were excluded. Baseline demographic data were recorded. Subjects under group A received standard treatment plus interferon inducer while group B received standard treatment alone. Interferon inducer in the form of orodispersible tablet was given for 5 days or until hospital discharge. Outcome measures were duration of hospitalization (days), temperature, complete blood count (CBC) and adverse effects (if any). SPSS-10 for Windows used. ANOVA, Chi-square test, Mann Whitney U test and Fisher Exact test and p-value of <0.05 were used to test for significance.

Results: A total of 120 subjects were included. The clinic-demographic characteristics of the patients in the two groups are similar, equally distributed between male and female, age ranging from 6 months to 18 years old, mostly admitted on their third day of illness. The length of hospitalization was notably shorter (p value <0.0001) among patients given interferon inducers with mean of 4.10 days. Period of fever defervescence (in days) was also shorter in patients given interferon inducers with mean of 2.18 days (p value 0.009). Increasing trend in platelet count was also earlier in patients given interferon inducers with mean of 3.88 days. (p value <0.0001). The drug has no significant effect on white blood cell count and hematocrit levels.

Conclusion: Interferon inducer affinity-purified antibodies to human interferon is a safe and effective adjunct therapy in the treatment of dengue in pediatric patients. The drug is also easy and safe to use, can alleviate the course of the disease, with no adverse effects reported.