Interferon-alpha-2a and zinc combination therapy in cildren 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-!2a (9 MU/m2 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.