Vitamin D supply in children with chronic viral hepatitis B

Abstract

Purpose — to investigate the vitamin D supply in children with chronic viral hepatitis B (HBV) depending on the activity of hepatitis and the stage of liver fibrosis. Materials and methods. Fifty children with HBV were examined. All children underwent a comprehensive examination according to the recommendation and elastography of the shear wave of the liver parenchyma to determine the stage of fibrosis. Serum 25(OH)D concentration was determined to verify the diagnosis of vitamin D deficiency. The peculiarities of vitamin D supply in children with HBV, depending on gender, age, hepatitis activity and stage of liver fibrosis, were evaluated. The study included children who did not receive calcium and vitamin D for 6 months. Results. Children of senior scholl age predomnanted among the surveyed. HBV was more often registered in boys 66.0% (n=33), while in girls — only 34.0% (n=17) (χ2=10.24; p=0.01). Among the examined children significantly more often 66.0% (n=33) we observed HBeAg-positive chronic hepatitis, 18.0% (n=9) children were diagnosed with HBeAg-positive chronic infection, HBeAg-negative chronic infection were determined in 14.0% (n=7) of children. In the vast majority (70.0%) of patients with HBV, the concentration of vitamin D in the serum was reduced (χ2=16.0; p=0.01). The average concentration of 25(OH)D was 59.85 [13.4–181] nmol/l and was in the zone of insufficiency. The optimal concentration of 25(OH)D was found in 30.0% (n=15) of children, insufficiency in 42.0% (n=21), vitamin D deficiency was diagnosed in 14 children (28.0%). Gender, age and biochemical activity of hepatitis do not affect the level of vitamin D in the examined children with HBV (p>0.05). The analysis of vitamin D supply depending on the stage of fibrosis did not reveal differences in the median concentration of 25(OH)D between groups of children, but in all groups the number of patients with low concentrations of vitamin D prevailed. Conclusions. HBV in children is characterized mainly by a chronic course, with a predominance of the parenteral route of infection. In most patients with HBV, the concentration of 25(OH)D in the serum is reduced. There was no statistically significant difference between the levels of vitamin D in children with HBV depending on gender, age, and biochemical activity of hepatitis. All children with cirrhosis of the liver were deficient in vitamin D. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: chronic viral hepatitis B, children, vitamin D, hepatitis activity, stage of fibrosis.

Neurological-Type Wilson Disease: Epidemiology, Clinical Manifestations, Diagnosis, and Management

“…A low ceruloplasmin level of less than 0.1 g/L accompanied with Kayser-Fleischer rings on a slit lamp examination is considered to establish the diagnosis of WD [ 17 ]. The sensitivity and specificity of this laboratory test are recorded to be 95% and 84.5% for diagnosing WD [ 21 ]. In addition, the slit lamp examination can confirm the presence of Kayser-Fleischer rings if WD is suspected [ 3 ].…”