Clinical Research: Hepatitis B in Pediatric Patients Treatment with Vitamin
Reviewed by Alan Gaby, MD
Author: Fiorino S, et al
Reference: Vitamin E for the treatment of E-antigen-positive chronic hepatitis B in paediatric patients: results of a randomized phase 2 controlled study. Liver Int 2017;37:54-61.
Design: Randomized, open-label trial.
Participants: Forty-three children (aged 2-17 years) with hepatitis B e-antigen (HBeAg)-positive chronic hepatitis B.
Study Medication and Dosage: Vitamin E (DL-alpha-tocopherol hydrogen succinate) at a dose of 15 mg per kg of body weight once a day for 12 months or no vitamin E (control group). The patients were monitored for a total of 24 months.
Primary Outcome Measure: The transition from active to inactive disease, as demonstrated by the disappearance of HBeAg, combined with the appearance of anti-HBe antibodies.
Key Findings: At the end of the study, the proportion of children who had transitioned from active to inactive disease was significantly higher in the vitamin E group than in the control group (30.4% vs. 4.3%; p < 0.05). There were no significant side effects.
Practice Implications: Chronic hepatitis B affects about 350 million people worldwide. It can cause chronic inflammation and liver cell death, potentially culminating in cirrhosis and hepatocellular carcinoma. Vitamin E stimulates immune activity and has been shown to be effective in the treatment of chronic hepatitis B in adults. The results of the present study demonstrate that vitamin E is also effective in the treatment of chronic hepatitis B in children.