Vitamin E for the treatment of E-antigen-positive chronic hepatitis B in paediatric patients: results of a randomized phase 2 controlled study

Liver Int. 2017 Jan;37(1):54-61. doi: 10.1111/liv.13192. Epub 2016 Jul 19.

Abstract

Background & aims: The treatment of chronic hepatitis B infection (CHB) in children is still an area of great uncertainty. Vitamin E is an immunostimulating/antioxidant compound proven to be safe and effective for the treatment of adult CHB. The aim of this phase 2 controlled study was to evaluate the safety and efficacy of vitamin E for the treatment of paediatric HBeAg-positive CHB.

Methods: Forty-six children were randomized in a 1:1 ratio to receive vitamin E at a dose of 15 mg/kg/day (in galenic preparation) or no treatment for 12 months and were monitored for the subsequent 12 months. Clinical, biochemical, haematological and serovirological evaluations were carried out every 3 months.

Results: No significant side effects were associated with the vitamin E treatment. At the end of the study, anti-HBe seroconversion was obtained in 7 of 23 (30.4%) of vitamin E-treated versus 1 of 23 (4.3%) of the control patients (P = 0.05), while a virological response (≥2 log decrease in HBV-DNA from baseline) was observed in 9 of 23 (39.1%) vs. 2 of 23 (8.7%) respectively (P = 0.035).

Conclusions: Vitamin E administration for the treatment of paediatric CHB at the tested dosage has no significant side effects and may induce anti-HBe seroconversion. Vitamin E could represent a tool for the treatment of paediatric CHB.

Keywords: chronic hepatitis B; paediatric infection; treatment; vitamin E.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Antioxidants / administration & dosage*
  • Antioxidants / adverse effects
  • Child
  • Child, Preschool
  • DNA, Viral / blood
  • Female
  • Hepatitis B Antibodies / blood
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Italy
  • Male
  • Prospective Studies
  • Sustained Virologic Response
  • Vitamin E / administration & dosage*
  • Vitamin E / adverse effects

Substances

  • Antioxidants
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B e Antigens
  • Vitamin E