Assessment of iron metabolism in children with chronic hepatitis B -- prognostic factor in interferon alpha therapy.
BACKGROUND
The aim of the study was to assess iron metabolism in children with chronic hepatitis B and to establish whether it had any influence on the results of interferon alpha therapy.


METHODS
The study was carried out in a group of 38 children aged from 2 to 16 years with chronic hepatitis B diagnosed according to serological, biochemical and histopathological criteria. All the patients were treated according to the commonly adopted schedule: interferon alpha administered subcutaneously three times a week at 3 MIU doses for 20 weeks. During the therapy and one-year follow-up after its completion, biochemical liver function parameters, serological HBV markers, and iron and ferritin levels were monitored.


RESULTS
The therapy resulted in obtaining seroconversion in the HBe system in 9 patients (23.68%). Liver bioptates in that group of patients demonstrated more advanced changes due to inflammatory activity and fibrosis processes, significantly higher values of alanine aminotransferase, lower serum levels of iron and ferritin with more pronounced difference in ferritin levels, although the differences reached no statistical significance.


CONCLUSIONS
No disturbances of iron metabolism were observed in children with chronic hepatitis B. In the group of patients with detectable seroconversion in the Hbe system resulting from interferon alpha therapy, lower serum levels of iron and ferritin were observed. Routine determinations of serum iron and ferritin levels as a prognostic factor for positive response to interferon alpha seem to be of little use, especially in children, in whom no iron accumulation in liver tissue is observed in histopathological assessment of liver bioptates
Chrobot
Andrzej
A
Department and Clinic of Pediatrics, Allergology and Gastroenterology, Medical University, Bydgoszcz, Poland.
Chrobot
Agnieszka Monika
AM
Szaflarska-Szczepanik
Anna
A
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007501:Iron / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000209:etiology / Q000378:metabolism; D008297:Male; D011379:Prognosis; D016896:Treatment Outcome
D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D005293:Ferritins; D007501:Iron; D000410:Alanine Transaminase