title: Pegylated interferon α/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection.
abstract: BACKGROUND
  The impact of chronic hepatitis C (CHC) on bone mineral density (BMD) has been well studied in adults with a relative paucity of data in children, especially concerning effect of treatment with pegylated interferon (PEG-IFN) plus ribavirin (RV). In the current work, we assessed prospectively changes in BMD in children with CHC before, during, and after treatment.
  
  
  METHODS
  Forty-six consecutive children with noncirrhotic genotype 4 CHC were subjected to dual-energy X-ray absorptiometry at baseline, 24 weeks, 48 weeks of therapy and 24 weeks after treatment. BMD, bone mineral content (BMC), and Z score of lumbar spine (L2-L4) were reported. Tanner pubertal stage, viral load, liver function tests, serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and liver histopathology were assessed in all included children.
  
  
  RESULTS
  Thirty (65.2%) patients had normal BMD, 10 (21.7%) were at risk for low BMD, and 6 (13.1%) had low BMD for chronological age. Patients with low BMD were significantly older (P=0.001), with higher frequency of delayed puberty than other groups (P=0.002). Baseline densitometric parameters (BMD & BMC) were significantly positively correlated with patients' age, weight, height, body mass index and hemoglobin level; while they were insignificantly correlated with basal viral load, histopathology activity index and fibrosis score. Densitometric parameters improved significantly on PEG-IFN plus RV treatment, this improvement was found to be sustainable 24 weeks after therapy.
  
  
  CONCLUSIONS
  Low BMD is detectable in a proportion of CHC children. Antiviral therapy leads to a sustainable increase in BMD.
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Al Gomhoria Street, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Megahed
authors.affiliation: Pediatric Endocrinology Unit, Mansoura University Children's Hospital, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Nanees
authors.initials: N
authors.lastname: Salem
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Al Gomhoria Street, Mansoura, Egypt. abeerfathy2000@yahoo.com.|Faculty of Medicine, Mansoura University, Mansoura, Egypt. abeerfathy2000@yahoo.com.
authors.forename: Abeer
authors.initials: A
authors.lastname: Fathy
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Al Gomhoria Street, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Tarik
authors.initials: T
authors.lastname: Barakat
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Al Gomhoria Street, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Mona Abd El Latif
authors.initials: MAEL
authors.lastname: Alsayed
authors.affiliation: Pediatric Hematology & Oncology Unit, Mansoura University Children's Hospital, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Suzy Abd El
authors.initials: SAE
authors.lastname: Mabood
authors.affiliation: Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Khaled R
authors.initials: KR
authors.lastname: Zalata
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Al Gomhoria Street, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed F
authors.initials: AF
authors.lastname: Abdalla
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D000367:Age Factors; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004534:Egypt; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage*; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha; D012254:Ribavirin
keywords: bone mineral density; chronic hepatitis C; pegylated interferon; ribavirin