KRONÝK HBV ENFEKSÝYONLU ÇOCUKLARDA TEDAVÝ ÖNCESÝ PLAZMA DEMÝR DÜZEYLERÝ INTERFERON TEDAVÝSÝNE VERÝLECEK YANIT ÝÇÝN PROGNOSTÝK FAKTÖR OLARAK KULLANILABÝLÝR MÝ? Pre-Treatment Plasma Iron Levels in Children with HBV Infection Could be Used As a Prognostic Factor Related to Outcome of Interferon (IFN) Therapy

Necati Balamtekin, Avni Atay, Ediz Yeþilkaya
2006 Research Reports) Erciyes Týp Dergisi (Erciyes Medical Journal)   unpublished
Özet Amaç: Bu çalýþmada kronik hepatit B virus(HBV) enfeksiyonlu çocuk hastalarda tedavi öncesi plazma demir düzeyinin interferon (IFN) tedavisinin sonucuyla ilgili prognostik faktör olarak kullanýlýp kullanýlamayacaðý araþtýrýldý. Hastalar ve Yöntem: Çalýþmaya kronik HBV enfeksiyonu olan 3-13 yaþ arasý 35 hasta ve 3-14 yaþ arasýnda 27 saðlýklý kontrol alýndý. Hastalara altý ay süreyle haftada üç kez 5 milyon U/m 2 dozunda IFN alfa-2a verildi. Hastalarýn tedavi öncesi ve tedavi bitiminden bir
more » ... vi bitiminden bir yýl sonra serum ALT ve HBV DNA ve karaciðer biyopsileri bakýldý. ALT'nin 40 IU/L altýna düþmesi biyokimyasal, HBV DNA'nýn negatifleþmesi virolojik, Knodell skorlamasýna göre histolojik olarak skorun 2 puan ve üzerinde azalmasý histopatolojik yanýt kabul edildi. Tedaviye yanýt veren hastalar grup I, vermeyenler grup II, kontrol grubu grup III olarak isimlendirildi. Plazma demir düzeyi alevli atomik absorbsiyon spektrofotometresi yöntemiyle ölçüldü. Bulgular: Üç kritere-biyokimyasal, virolojik, histopatolojik-yanýta göre de grup I ve grup lI'nin tedavi öncesi ortalama plazma demir düzeyleri arasýnda fark gözlenmedi (p>0.05). Hem grup I hem grup lI'nin tedavi öncesi demir düzeyleri ile grup III'ün demir düzeyleri arasýnda fark gözlenmedi (p>0.05). Sonuç: Sonuçlar kronik HBV enfeksiyonlu çocuk hastalarýn tedavi öncesi plazma demir düzeyinin IFN tedavisinin sonucuyla ilgili bir prognostik faktör olarak kullanýlamayacaðýný düþündürmektedir. Anahtar Kelimeler: Çocuk; Demir; Hepatit B; Ýnterferon alfa-2a; Tedavi. Abstract Aims: The aim of this study was to determine whether the pre-treatment plasma iron levels could be used as a prognostic factor, related to the outcome of interferon (IFN) therapy, in children with HBV infection Patients and Methods: The study was carried out on a group of 35 patients aged from 3 to 13 years with HBV infection treated with IFN and 27 healthy control subjects aged from 3 to 14. IFN alpha 2a was administered at a dose of 5 mil U/m² three times a week for 6 months. Serum ALT levels and HBV DNA were measured and liver biopsies performed one year before and after the completion of the treatment. Biochemical response was accepted as a reduction of serum ALT levels under 40 IU/L, virological response disappearance of HBV DNA, histopathologic response as a reduction is histologic score by two points or more according to KnodelI histological scoring system. Patients responding to treatment were named as group I, not-responders as group II and controls as group III. Absorption spectrophotometry was used to determine plasma iron level. Results: In respect to three criteria-biochemical, virological and histopathological, pre-treatment plasma iron levels were not found to be statistically different between groups I and II (p>0.05). Pre-treatment plasma iron levels of group I and II were not different from those of group III (p>0.05). Conclusion: The results of this study suggest that pre-treatment plasma iron levels in children with HBV infection cannot be used as a prognostic factor related to the outcome of IFN therapy.
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