title: Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess vitamin E efficacy, defined as its ability to induce hepatitis B e antigen (HBeAg) seroconversion, in children with HBeAg-positive persistent hepatitis.
  
  
  METHODS
  In July 2016, we extracted articles published in MEDLINE and the Cochrane Library using the following search terms: "chronic hepatitis B", "children", "childhood", "therapy", "treatment", "vitamin E", "tocopherols", "tocotrienols". Only randomized controlled trials (RCTs) published in English language were collected.
  
  
  RESULTS
  Three RCTs met inclusion criteria and were considered in the present meta-analysis. Overall, 23/122 children in the treatment group underwent HBeAg seroconversionvs3/74 in the control group (OR = 3.96, 95%CI: 1.18-13.25,P= 0.025).
  
  
  CONCLUSIONS
  Although our meta-analysis has several limits, including the very small number of available studies and enrolled children with HBeAg positivity-related hepatitis, it suggests that vitamin E use may enhance the probability to induce HBeAg seroconversion in these patients. Further well designed and adequately sized trials are required to confirm or deny these very preliminary results.
authors.affiliation: Sirio Fiorino, Paolo Leandri, Unità Operativa di Medicina Interna C, Ospedale Maggiore, AUSL Bologna, 40100 Bologna, Italy.
authors.forename: Sirio
authors.initials: S
authors.lastname: Fiorino
authors.affiliation: Sirio Fiorino, Paolo Leandri, Unità Operativa di Medicina Interna C, Ospedale Maggiore, AUSL Bologna, 40100 Bologna, Italy.
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Bacchi-Reggiani
authors.affiliation: Sirio Fiorino, Paolo Leandri, Unità Operativa di Medicina Interna C, Ospedale Maggiore, AUSL Bologna, 40100 Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Leandri
authors.affiliation: Sirio Fiorino, Paolo Leandri, Unità Operativa di Medicina Interna C, Ospedale Maggiore, AUSL Bologna, 40100 Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Loggi
authors.affiliation: Sirio Fiorino, Paolo Leandri, Unità Operativa di Medicina Interna C, Ospedale Maggiore, AUSL Bologna, 40100 Bologna, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
keywords: Hepatitis B; Immunology; Pediatric hepatology; Viral hepatitis