MMWR Morb Mortal Wkly Rep. 2009 Aug 14;58(31):854-6.
Artemisinins are a class of compounds that include artesunate, artemether, and artemisinin and have potent antimalarial activity. In combination with other drugs (artemisinin combination therapy), these compounds are the first-line treatment recommended by the World Health Organization for Plasmodium falciparum infections. Artemisinins have been available in the United States without a prescription as herbal supplements for at least 10 years; these supplements are marketed for general health maintenance and for treatment of parasitic infections and cancers. On August 27, 2008, CDC was notified of a patient who developed hepatitis after a 1-week course of an herbal supplement containing artemisinin. The patient had abdominal pain, dark urine, and laboratory results consistent with hepatitis (e.g., serum alanine aminotransferase of 898 IU/L [normal: 10-55 IU/L]). Samples of the supplement were sent to CDC and the Georgia Institute of Technology for analysis to determine the amount of artemisinin and to identify any contaminants. Analysis indicated that the supplement contained 94%-97% of the 100 mg of artemisinin stated on the packaging and the supplement contained no other common pharmaceutical active ingredients. Given the patient's clinical course and laboratory evaluation, CDC investigators concluded that the hepatitis might have been associated with ingestion of the herbal supplement containing artemisinin. More data are needed to establish any causal connection between artemisinin and hepatitis. Health-care providers should be aware of the possibility of hepatic toxicity in patients taking herbal supplements containing artemisinin.
青蒿素是一类化合物，包括青蒿琥酯、蒿甲醚和青蒿素，具有强大的抗疟活性。与其他药物联合使用（青蒿素联合疗法）时，这些化合物是世界卫生组织推荐用于治疗恶性疟原虫感染的一线药物。青蒿素在美国作为草药补充剂无需处方即可获得，至少已有10年时间；这些补充剂用于一般健康维护以及治疗寄生虫感染和癌症。2008年8月27日，美国疾病控制与预防中心（CDC）接到通知，一名患者在服用含青蒿素的草药补充剂1周后出现肝炎。该患者有腹痛、深色尿液，实验室检查结果符合肝炎表现（例如，血清丙氨酸氨基转移酶为898 IU/L[正常范围：10 - 55 IU/L]）。该补充剂样本被送往CDC和佐治亚理工学院进行分析，以确定青蒿素含量并识别任何污染物。分析表明，该补充剂所含青蒿素为包装标注100毫克的94% - 97%，且不含其他常见的药物活性成分。根据患者的临床病程和实验室评估，CDC调查人员得出结论，肝炎可能与摄入含青蒿素的草药补充剂有关。需要更多数据来确定青蒿素与肝炎之间的因果关系。医疗保健人员应意识到服用含青蒿素草药补充剂的患者存在肝毒性的可能性。
