Vitamin E treatment for children with chronic hepatitis B: A randomized placebo controlled trial

Gerner, Patrick; Posselt, Hans-Georg; Krahl, Andreas; Ballauff, Antje; Innerhofer, Albina; Binder, Christa; Wenzl, Tobias G.; Zense, Matthias; Hector, Ariadne; Dockter, Gerhard; Adam, R D; Neubert, Jenny; Claßen, Martin; Gemmern, Robert van; Wirth, Stéfan

doi:10.3748/wjg.14.7208

Cited by 19 publications

(30 citation statements)

References 34 publications

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“…Vitamin E as an antioxidant therapy showed no significant difference for SRR compared with placebo among children with CHB [31], in disagreement with a study in adults [54]. Both paediatric and adult studies did not report the status of HBsAg and the effect of vitamin E on the liver pathology.…”

Section: Discussionmentioning

confidence: 84%

“…The follow-up period in most studies was from 6 months up to 1 year [15,17,24,25,27,30,31], and in one was of 2 years [18]. Treatment was conducted among children with CHB in the immunoactive phase in all studies, except two studies in which it was conducted in the immunotolerant phase [25,30].…”

Section: Studies Descriptionmentioning

confidence: 98%

“…Several studies had an open label design [12][13][14][15][16]25,26], while the others were randomized controlled studies, where the control group could be: no treatment [17][18][19][20][29][30][31], another therapeutic regimen [22,24,27,28], different doses of the same drug [23], or different durations of treatment [21].…”

Section: Studies Descriptionmentioning

confidence: 99%

“…1 highlights the articles' inclusion process. Twenty studies (1112 cases) were eligible; 9 for IFN␣ monotherapy [12][13][14][15][16][17][18][19][20], 6 for combined IFN plus LMV [21][22][23][24][25][26], 2 for IFN␣ plus immune modulators [27,28], 2 for IFN␣ plus prednisone [18,29], 1 for hepatitis B vaccine [30], and 1 for vitamin E [31], (Ref. [18] was used for 2 regimens).…”

Section: Studies Descriptionmentioning

confidence: 99%

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Treatment of children with HBeAg-positive chronic hepatitis B: A systematic review and meta-analysis

Sherbini

Omar

2014

Digestive and Liver Disease

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Section: Discussionmentioning

confidence: 84%

Section: Studies Descriptionmentioning

confidence: 98%

Section: Studies Descriptionmentioning

confidence: 99%

Section: Studies Descriptionmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of children with HBeAg-positive chronic hepatitis B: A systematic review and meta-analysis

Sherbini

Omar

2014

Digestive and Liver Disease

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“…Die Unterschiede waren jedoch nicht signifikant und stellen nur einen Trend dar, der an größeren Patientenkollektiven überprüft werden muss [8].…”

Section: α-Interferonunclassified

Hepatitis B and C in childhood

Gerner

Wirth

2009

Monatsschr Kinderheilkd

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Bei Kindern ist die Therapie einer chronischen Hepatitis B in der hochvirämischen Phase indiziert, falls die Transaminasen mehrmals erhöht waren oder eine Leberfibrose ab Grad 2 oder soziale Umstände eine HBV(Hepatitis-B-Virus)-Suppression nötig machen. Die Behandlung mit α-Interferon (IFN-α) ist die Therapie der 1. Wahl. Sie führt bei 26-38% der Patienten zu einer AntiHBe("hepatitis B protein e antigen")-Serokonversion. Bei erfolgloser Therapie oder Kontraindikationen gegen IFN kommt Lamivudin in Frage, wodurch in 20-25% nach 12 Monaten eine AntiHBe-Serokonversion erzielt wird. Die Therapie mit Nukleosid-bzw. Nukleotidanaloga sollte bis 6 Monate nach Serokonversion durchgeführt werden, was meist einer Langzeittherapie über mehrere Jahre entspricht. Aufgrund der Entwicklung viraler Resistenzen ist eine langfristige Therapieplanung unabdingbar. Bei chronischer Hepatitis C können mit einer Kombinationsbehandlung von IFN-α je nach Virusgenotyp 50-90% der Kinder geheilt werden. Bei erfolgloser Behandlung ist eine Retherapie zu erwägen. Protease-und Polymeraseinhibitoren werden zurzeit in klinischen Studien an Erwachsenen getestet und könnten in Zukunft die Therapie erweitern. AbstractThe development of new medications and therapy regimes has expanded the therapy of hepatitis B and C during the last years. In childhood therapy of chronic hepatitis B is indicated during the high viral phase if transaminase levels are increased on several occasions or if liver fibrosis above grade 2 is present or if social conditions necessitate hepatitis B virus suppression. Treatment with α-interferon is the therapy of choice and leads to seroconversion of anti-HBe in 26-38% of patients. In non-responders or contraindications against the use of interferon lamivudin can be used. After a period of 12 months these therapies lead to seroconversion of anti-HBe in 20-25% of patients and subsequently to the loss of HBeAg and a dramatic decrease of HBV-DNA and mostly also transaminases. Nowadays, therapy with nucleoside and nucleotide analogues should be given until seroconversion to anti-HBe has been achieved but in most cases this involves a long term therapy lasting several years. Therefore, exact knowledge of the characteristics of the currently available nucleosides is crucial. Chronic hepatitis C can be cured in 50-90% of children through combined treatment with alpha-interferon and ribavirin. If treatment is unsuccessful the therapy can be repeated. Medications such as protease and polymerase inhibitors are currently being tested in clinical studies on adults and in some years could be an extension to the clinical therapy.

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Reactive Oxygen Species (ROS) and Liver Disease Therapy

Bellanti

Sastre

Serviddio

2014

Systems Biology of Free Radicals and Antioxidants

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Vitamin E treatment for children with chronic hepatitis B: A randomized placebo controlled trial

Abstract: There is only a tendency that Vitamin E may promote HBeAg seroconversion. Therefore larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis B.

Cited by 19 publications

References 34 publications

Treatment of children with HBeAg-positive chronic hepatitis B: A systematic review and meta-analysis

Treatment of children with HBeAg-positive chronic hepatitis B: A systematic review and meta-analysis

Hepatitis B and C in childhood

Reactive Oxygen Species (ROS) and Liver Disease Therapy

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