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Pegylated interferon ¦Á/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection 
Pegylated interferon ¦Á/ribavirin therapy enhances bone mineral density in children with chronic genotype 4 HCV infection
  Ahmed Megahed, Nanees Salem, Abeer Fathy, Tarik Barakat, Mona Abd El Latif Alsayed, Suzy Abd El Mabood, Khaled R Zalata, Ahmed F Abdalla
 [Abstract] [Full Text] [PDF]   Pageviews: 332 Times
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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