Assessment of iron metabolism in children with chronic hepatitis B - prognostic factor in interferon alpha therapy.
Agnieszka Monika Chrobot, Andrzej Chrobot, Anna Szaflarska-Szczepanik
Med Sci Monit 2002; 8(4): CR269-273
BACKGROUND: The aim of the study was to assess iron metabolism in childrenwith chronic hepatitis B and to establish whether it had any influence on the results of interferon alphatherapy. MATERIAL/METHODS: The study was carried out in a group of 38 children aged from 2 to 16 yearswith chronic hepatitis B diagnosed according to serological, biochemical and histopathological criteria.All the patients were treated according to the commonly adopted schedule: interferon alpha administeredsubcutaneously three times a week at 3 MIU doses for 20 weeks. During the therapy and one-year follow-upafter its completion, biochemical liver function parameters, serological HBV markers, and iron and ferritinlevels were monitored. RESULTS: The therapy resulted in obtaining seroconversion in the HBe system in9 patients (23.68%). Liver bioptates in that group of patients demonstrated more advanced changes dueto 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, althoughthe differences reached no statistical significance. CONCLUSIONS: No disturbances of iron metabolismwere observed in children with chronic hepatitis B. In the group of patients with detectable seroconversionin the Hbe system resulting from interferon alpha therapy, lower serum levels of iron and ferritin wereobserved. Routine determinations of serum iron and ferritin levels as a prognostic factor for positiveresponse to interferon alpha seem to be of little use, especially in children, in whom no iron accumulationin liver tissue is observed in histopathological assessment of liver bioptates
Keywords: Adolescent, Alanine Transaminase, Antiviral Agents, Child, Child, Preschool, Female, ferritin, Follow-Up Studies, Hepatitis B Antibodies, Hepatitis B e Antigens, Hepatitis B, Chronic, Humans, Interferon-alpha, Iron, Liver Cirrhosis, Male, Prognosis, Treatment Outcome