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Pegylated interferon α/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection

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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.

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Authors and Affiliations

  1. Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children’s Hospital, Al Gomhoria Street, Mansoura, Egypt

    Ahmed Megahed, Abeer Fathy, Tarik Barakat, Mona Abd El Latif Alsayed & Ahmed F. Abdalla

  2. Pediatric Endocrinology Unit, Mansoura University Children’s Hospital, Mansoura, Egypt

    Nanees Salem

  3. Pediatric Hematology & Oncology Unit, Mansoura University Children’s Hospital, Mansoura, Egypt

    Suzy Abd El Mabood

  4. Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Ahmed Megahed, Nanees Salem, Abeer Fathy, Tarik Barakat, Mona Abd El Latif Alsayed, Suzy Abd El Mabood & Ahmed F. Abdalla

  5. Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Khaled R. Zalata

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  1. Ahmed Megahed
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Correspondence to Abeer Fathy.

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Megahed, A., Salem, N., Fathy, A. et al. Pegylated interferon α/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection. World J Pediatr 13, 346–352 (2017). https://doi.org/10.1007/s12519-017-0013-x

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  • DOI: https://doi.org/10.1007/s12519-017-0013-x

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