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Antiviral Res 1999 Sep;43(2):113-22
Interferon/antioxidant combination therapy for chronic hepatitis C
- ontrolled pilot trial.
Look MP, Gerard A, Rao GS, Sudhop T, Fischer HP, Sauerbruch T,
Spengler U Department of General Internal Medicine, University of
Bonn, Germany. look@uni-bonn.de
[Medline record in process]
The effects of two forms of antioxidative co-therapy were
analyzed in 24 interferon-alpha (IFN)-naive patients with chronic
hepatitis C who were randomized to either receive IFN monotherapy
(3 x 4.5 million units IFN-alpha 2a per week), (group A), or IFN
and N-acetylcysteine (N-acetylcysteine (NAC) 1.800 mg/day) plus
sodium selenite (400 microg/day) supplementation (group B), or
treatment as in group B plus vitamin E (544 IU/day) (group C), over
24 weeks. Changes in histology, normalization of ALT, reduction of
viral RNA, serum levels of glutathione, selenium, vitamin E,
erythrocyte glutathione peroxidase, trolox equivalent antioxidative
capacity (TEAC), thiobarbituric acid reactive substances (TBARS)
and protein carbonyl groups were measured. Low baseline TEAC and
elevated TBARS indicated increased oxidative stress before therapy,
which was not affected by antioxidant supplementation. At the end
of treatment complete responses were found in 3/8, 2/8 and 6/8
patients in groups A, B and C, respectively, but liver histology
had not significantly improved. Vitamin E treated patients had a
2.4 greater chance (95% CI: 1.05-5.5) of obtaining a complete
response and had significantly greater reduction in viral load (P =
0.028) than patients without vitamin E. Relapses, i.e.
re-appearance of detectable hepatitis C virus (HCV) RNA and/or
re-elevation of ALT-activity occurred in 7 out of the 11 responders
within 6 months after termination of therapy (group A: 2/3, group
B: 1/2 and group C: 4/6). Thus, no overall beneficial effect of
antioxidant/IFN therapy was detected. However, the apparent trend
towards a more favorable outcome with vitamin E supplementation
warrants to further study this substance as an adjuvant to IFN
therapy in chronic hepatitis C.
PMID: 10517313, UI: 99444901
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