Efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B infection

• Published in: Pediatrics international 2007-10, Vol.49 (5), p.603-607
• Main Authors: DIKICI, BUNYAMIN, DAGLI, ABDULLAH, UCMAK, HASAN, BILICI, MEKI, ECE, AYDIN
• Format: Article
• Language: English
• Subjects: Alanine Transaminase - blood; Child; children; chronic hepatitis B; Female; Hepatitis B virus; Hepatitis B virus - genetics; Hepatitis B virus - isolation & purification; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - enzymology; Hepatitis B, Chronic - immunology; Humans; Immune Tolerance; immunotolerant phase; Male; therapy; Viral Load; vitamin E; Vitamin E - therapeutic use
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/j.1442-200X.2007.02419.x

Background: The purpose of the present paper was to investigate the efficacy of vitamin E in children with immunotolerant‐phase chronic hepatitis B virus (CHB) infection. Methods: Fifty‐eight immunotolerant children were prospectively and randomly recruited into two groups. Group 1 (study group) included 30 patients who received vitamin E at a dose of 100 mg/day throughout 3 months; group 2 (control group) contained 28 patients who did not receive any medication. Comparison of serological, virologic, and biochemical response ratios were done at the end of the therapy and after 6 months of vitamin E discontinuation. Results: Mean alanine transaminase (ALT) values in group 1 at the beginning of the therapy, 3 months after the therapy initiation and 6 months after discontinuation were 30.4 ± 7.3 IU/L, 31.3 ± 7.8 IU/L and 32.1 ± 8.5 IU/L, respectively. The mean hepatitis B virus (HBV)‐DNA load of group 1 at onset, and at the third and ninth months of the treatment were 3106 ± 718 pg/mL, 3530 ± 137 pg/mL and 3364 ± 1246 pg/mL, respectively. These changes in both ALT and HBV‐DNA values did not reach significant levels (P > 0.05). In group 2, mean ALT values at the beginning of therapy, and at the third and ninth months were 28.0 ± 1.8 IU/L, 34.6 ± 8.1 IU/L, and 34.1 ± 7.0 IU/L, respectively (P > 0.05), and mean viral load of HBV‐DNA was 4227 ± 1435 pg/mL, 3368 ± 2673 pg/mL, and 3018 ± 2814 pg/mL, respectively (P > 0.05). There was no statistically significant difference between group 1 and group 2 at the third and ninth months in the mean ALT values and viral load of HBV‐DNA (P > 0.05). Hepatitis B s antigen and hepatitis B e antigen clearance or hepatitis B s antibody and hepatitis B e antibody seroconversion were not observed in either group. Conclusion: As a first study investigating the effect of vitamin E in children with immunotolerant CHB infection, no beneficial effect could be demonstrated. Different immunomodulator protocols should be considered for future investigations.