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Nutritional status and growth in children with chronic hepatitis B
A Vegnente1, S Guida, V Di Costanzo
1Department of Pediatrics, University of Naples, Italy.
Insights
Chronic hepatitis B virus (HBV) infection in children did not cause malnutrition. Nutritional status improved when children on restrictive diets received adequate caloric intake, demonstrating diet
Area of Science:
- Pediatrics
- Hepatology
- Nutritional Science
Background:
- Chronic hepatitis B virus (HBV) infection is associated with malnutrition in other liver diseases.
- The impact of chronic HBV infection on pediatric malnutrition and growth requires further investigation.
Purpose of the Study:
- To determine if chronic HBV infection causes malnutrition and affects growth in children.
- To assess the nutritional status and growth patterns of children with chronic HBV infection over a 4-year period.
Main Methods:
- Longitudinal study of 75 children with chronic HBV infection over 4 years.
- Nutritional status evaluated annually using physical examinations, laboratory tests, and Waterlow criteria.
- Dietary intake, including caloric and fat content, was assessed at baseline.
Main Results:
- No biochemical evidence of malnutrition was observed in any of the 75 children.
- Children on restrictive low-fat diets with inadequate caloric intake exhibited growth failure.
- Weight gain was observed in these children upon normalization of dietary intake.
Conclusions:
- Chronic HBV infection itself does not appear to cause malnutrition in children.
- Growth failure observed in some children was linked to inadequate caloric intake due to restrictive diets, not the HBV infection.
- Nutritional status was satisfactory for all children by the end of the follow-up period after dietary adjustments.
Abstract:
As reported for other chronic liver diseases, hepatitis B virus (HBV) chronic infection might result in malnutrition. In order to establish whether this disease could be responsible of malnutrition and hence influence growth, 75 children, chronically infected with HBV, have been followed up for 4 years. Thirty-one of them had chronic active hepatitis (CAH), 25 chronic persistent hepatitis (CPH), 14 chronic lobular hepatitis (CLH), and five cirrhosis (three active, two inactive). The nutritional status was evaluated every 12 months, with careful physical and laboratory examinations. General nutritional status was estimated according to Waterlow criteria (13, 14). At our first observation, 50 children were following a balanced diet with a caloric intake adequate for age and weight, whereas 25 were on a low-fat diet, begun in the belief of its therapeutic value. For seven patients of this second group, the caloric intake was below the daily requirement. The latter group showed a growth failure in weight when they were first seen at our center and gained weight when the dietary intake was normalized. However, no biochemical feature of malnutrition was observed in all the 75 children. At the end of the follow-up period, the nutritional status was satisfactory for all of them.