Published online Feb 28, 2017. doi: 10.4254/wjh.v9.i6.333
Peer-review started: October 8, 2016
First decision: November 10, 2016
Revised: December 24, 2016
Accepted: January 16, 2017
Article in press: January 18, 2017
Published online: February 28, 2017
To assess vitamin E efficacy, defined as its ability to induce hepatitis B e antigen (HBeAg) seroconversion, in children with HBeAg-positive persistent hepatitis.
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.
Three RCTs met inclusion criteria and were considered in the present meta-analysis. Overall, 23/122 children in the treatment group underwent HBeAg seroconversion vs 3/74 in the control group (OR = 3.96, 95%CI: 1.18-13.25, P = 0.025).
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.
Core tip: Treatment of chronic hepatitis B in children is still an area of uncertainty. Vitamin E, based on immunostimulatory anti-inflammatory activity, has been evaluated in the treatment of pediatric hepatitis B virus infection. These few experiences seem to be encouraging as they suggest a potential role of vitamin E in inducing HBeAg seroconversion, but they need to be confirmed in well-designed and adequately-sized trials.