title: Efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B infection.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Abant Izzet Baysal University, Duzce Medical Faculty, Duzce, Turkey. bdikici@hotmail.com
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Dikici
authors.forename: Abdullah
authors.initials: A
authors.lastname: Dagli
authors.forename: Hasan
authors.initials: H
authors.lastname: Ucmak
authors.forename: Meki
authors.initials: M
authors.lastname: Bilici
authors.forename: Aydin
authors.initials: A
authors.lastname: Ece
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000201:enzymology / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D019562:Viral Load; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D014810:Vitamin E; D000410:Alanine Transaminase