Plasma and liver carnitine levels of children with chronic hepatitis B

Carnitine status of children with chronic hepatitis B is not yet clear. Because it is well-known that carnitine interferes with T-cell immunity, which is closely related to spontaneous or treatment-induced seroconversion in hepatitis B, it was hypothesized that carnitine status would be effective on the end of therapy response (ETR). The aim of this study is to investigate both carnitine status of children with chronic HBV infection and its probable effects on liver histology and ETR.

Thirty-one children with chronic HBV infection, and age and sex matched 20 healthy children were included in the study. Plasma and liver free carnitine level determination was performed before IFN-alpha and lamivudine combination therapy in children with chronic hepatitis B. Mean plasma carnitine level of healthy children was used as control. IFN-alpha was injected as 5 million U/m2 subcutaneously 3 times a week for 6 months and lamivudine 4 mg/kg per day orally, maximum of 100 mg, for 1 year.

The mean plasma carnitine level of patients with chronic HBV infection was significantly lower than that of controls (P < 0.001) The ETR was achieved in 14 (45.2%) patients. While plasma carnitine level was inversely correlated with portal inflammation score (P < 0.05), liver carnitine level was inversely correlated with fibrosis score (P < 0.05).

It was found that plasma carnitine level was lower in children with chronic hepatitis B compared with healthy ones and carnitine was inversely correlated with liver portal inflammation and fibrosis scores. The role of carnitine in immunopathogenesis and histology of HBV needs to be clarified with further studies.