Vitamin E for the treatment of children with hepatitis B e antigen-positive chronic hepatitis:a systematic review and meta-analysis

AIM To assess vitamin E efficacy,defined as its ability to induce hepatitis B e antigen(HBeAg) seroconversion,in children with HBeAg-positive persistent hepatitis.METHODS 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.RESULTS 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).CONCLUSION 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.