Andreone P, Fiorino S, Cursaro C, Gramenzi A, Margotti M, Di Giammarino L, Biselli M, Miniero R, Gasbarrini G, Bernardi M
Semeiotica Medica, Dipartimento di Medicina Interna, Cardioangiologia ed Epatologia, Università di Bologna, Policlinico Sant'Orsola, Via Massarenti, 9, 40138, Bologna, Italy.
Antiviral Res. 2001 Feb;49(2):75-81. doi: 10.1016/s0166-3542(00)00141-8.
Interferon-alpha treatment has been the treatment of choice for chronic hepatitis with unpredictable results. Recently, Lamivudine has been licensed for use against HBV infection with good results. Unfortunately, recurrence of viremia after lamivudine withdrawal is common and prolonged treatment can induce the emergence of resistant mutant strains. It has been shown that vitamin E can increase the host immune response, and this may provide protection against infectious diseases.
We evaluated vitamin E supplementation as therapy for chronic hepatitis B in a pilot study including 32 patients. Patients were randomly allocated to receive vitamin E at the dose of 300 mg twice daily for 3 months (15 patients) or no treatment (17 patients). They were seen monthly during the first 3 months and thereafter quarterly for additional 12 months.
The two groups were comparable at enrollment. At the end of the study period, alanine aminotransferase (ALT) normalization was observed in 7 (47%) patients in vitamin E group and only in 1 (6%) of the controls (P=0.011); HBV-DNA negativization was observed in 8 (53%) patients in the vitamin E group as compared to 3 (18%) in the control group, respectively (P=0.039). A complete response (normal ALT and negative HBV-DNA) was obtained in 7 (47%) patients taking vitamin E and in none of the controls (P=0.0019).
Vitamin E supplementation might be effective in the treatment of chronic hepatitis B.
干扰素-α治疗一直是慢性肝炎的首选治疗方法，但疗效难以预测。最近，拉米夫定已被批准用于治疗HBV感染，效果良好。不幸的是，停用拉米夫定后病毒血症复发很常见，长期治疗可诱导耐药突变株的出现。已有研究表明，维生素E可增强宿主免疫反应，这可能为预防传染病提供保护。
我们在一项纳入32例患者的初步研究中评估了补充维生素E作为慢性乙型肝炎治疗方法的效果。患者被随机分为两组，15例患者每日两次服用300mg维生素E，疗程3个月；17例患者不接受治疗。在最初3个月内每月对患者进行观察，之后每季度观察一次，持续12个月。
两组患者入组时情况相当。在研究期末，维生素E组有7例（47%）患者丙氨酸转氨酶（ALT）恢复正常，而对照组仅有1例（6%）恢复正常（P=0.011）；维生素E组有8例（53%）患者HBV-DNA转阴，对照组为3例（18%）（P=0.039）。服用维生素E的患者中有7例（47%）获得完全缓解（ALT正常且HBV-DNA阴性），而对照组无1例获得完全缓解（P=0.0019）。
补充维生素E可能对慢性乙型肝炎治疗有效。
