title: Interferon-alpha-2a and zinc combination therapy in children with chronic hepatitis B infection.
abstract: Zinc has been reported to enhance the response to interferon (IFN) or PEG-IFN plus ribavirin therapy, improve liver function, and ameliorate hematologic side effects in patients with chronic hepatitis C. However, the role of zinc supplementation during IFN therapy in chronic hepatitis B infection (CHB) remains unclear. We therefore aimed to report the results of zinc and IFN-alpha-2a therapy in children with CHB. Twenty-two naive, HBeAg-positive children (mean age 10.4 ± 4.4 years) received IFN-α2a (9 MU/m(2) sc) for 6 months plus peroral zinc (7.5 mg/day for <10 years and 10 mg/day for >10 years) for 12 months. Serum zinc, alanine aminotransferase (ALT), complete blood count, hepatitis B virus DNA (HBV DNA), and serological markers were measured. Histological (HR) and sustained response (SR) were evaluated at 6 months after completion of therapy. Normalization of ALT, HBeAg seroconversion, and HBV DNA < 10,000 copies/ml were considered as SR. HR was defined as decrease in Knodell histological activity index (HAI) score by at least 2 points compared to baseline. End of therapy ALT level and log HBV DNA were significantly lower than pretherapy levels (p = 0.001 and p = 0.001, respectively), while zinc level was not different. Portal inflammation score significantly decreased after therapy (p = 0.043), however, total HAI and other HAI components were not different. SR and HR were 25% and 52.9%. In conclusion as a first study investigating the effect of zinc and IFN combination therapy in children with CHB, SR and HR rates were not better than previously reported monotherapy or combination therapies.
authors.affiliation: Department of Pediatric Gastroenterology, Ankara University, School of Medicine, Ankara, Turkey. zarifekuloglu@yahoo.com
authors.forename: Zarife
authors.initials: Z
authors.lastname: Kuloğlu
authors.forename: Gülnihan
authors.initials: G
authors.lastname: Kırbaş
authors.forename: Esra
authors.initials: E
authors.lastname: Erden
authors.forename: Aydan
authors.initials: A
authors.lastname: Kansu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D015032:Zinc / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015032:Zinc