摘要
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.
作者简介
Corresponding Author:Abeer Fathy,MD,Pediatric Gastmentemlogy and Hepatology Unit,Mansoura University Children’s Hospital,Al Gomhoria Street,Mansoura,Egypt(Tel:+2 01 224642996;Fax:+2 0502220679;Email:abeerfathy2000@yahoo.com)
