Gabbay Ezra, Zigmond Ehud, Pappo Orit, Hemed Nila, Rowe Mina, Zabrecky George, Cohen Robert, Ilan Yaron
Liver Unit, Department of Medicine, Hebrew University, Hadassah Medical Center, POB 12000, Jerusalem IL-91120, Israel.
World J Gastroenterol. 2007 Oct 28;13(40):5317-23. doi: 10.3748/wjg.v13.i40.5317.
To assess the safety and efficacy of antioxidant therapy for patients with chronic hepatitis C virus (HCV) infection.
One hundred chronic HCV infection patients failed in interferon treatment were enrolled and randomly assigned to receive combined intravenous and oral antioxidants or placebo, or oral treatment alone. Primary end points were liver enzymes, HCV-RNA levels and histology.
Combined oral and intravenous antioxidant therapy was associated with a significant decline in ALT levels in 52% of patients who received antioxidant therapy vs 20% of patients who received placebo (P = 0.05). Histology activity index (HAI) score at the end of treatment was reduced in 48% of patients who received antioxidant therapy vs 26% of patients who received placebo (P = 0.21). HCV-RNA levels decreased by 1-log or more in 28% of patients who received antioxidant therapy vs 12% who received placebo (P = NS). In part II of the trial, oral administration of antioxidants was not associated with significant alterations in any of the end points.
Antioxidant therapy has a mild beneficial effect on the inflammatory response of chronic HCV infection patients who are non-responders to interferon. Combined antiviral and antioxidant therapy may be beneficial for these patients.
评估抗氧化剂疗法对慢性丙型肝炎病毒(HCV)感染患者的安全性和疗效。
招募100例干扰素治疗失败的慢性HCV感染患者,随机分配接受静脉和口服联合抗氧化剂或安慰剂,或仅接受口服治疗。主要终点为肝酶、HCV-RNA水平和组织学。
接受抗氧化剂治疗的患者中52%的丙氨酸转氨酶(ALT)水平显著下降,而接受安慰剂的患者中这一比例为20%(P = 0.05)。接受抗氧化剂治疗的患者中48%的患者治疗结束时组织学活动指数(HAI)评分降低,而接受安慰剂的患者中这一比例为26%(P = 0.21)。接受抗氧化剂治疗的患者中28%的患者HCV-RNA水平下降1个对数或更多,而接受安慰剂的患者中这一比例为12%(P = 无统计学意义)。在试验的第二部分,口服抗氧化剂与任何终点指标的显著变化均无关。
抗氧化剂疗法对干扰素无反应的慢性HCV感染患者的炎症反应有轻微有益作用。联合抗病毒和抗氧化剂疗法可能对这些患者有益。