Could Inosine pranobex and Ribavirin in combination restore immune competence in chronic HCV advanced liver disease?

Abstract

The management of patients with advanced chronic HCV liver disease is still a problem. There is insufficient data about the role of immunomodulatory agents. The aim of the present study was to evaluate the benefit of prolonged co-administration of Inosine pranobex (Isoprinosine) and Ribavirin in patients with HCV advanced liver disease and to assess the dynamics of the IP-10 serum levels and thus -changes in the immune status of patients. Methods: Five patients (2 males, 3 females; median age 63), with chronic HCV genotype 1 infection were studied (with failed standard bitherapy). All patients received Ribavirin and Isoprinosine. HCVRNA was measured at baseline and at day 40, month 3, 6 and 12 during treatment. IP-10 levels -at baseline and at day 10, 20, 40, 60, month 3, 6 and 12. Results: IP-10 levels were elevated in all patients at the baseline. An increase at day 10 or 20 was found in 4/5 patients and reduction at day 40 or 60 in same 4 patients. At month 12 the levels were significantly reduced (P=0.043). There was also an initially slight increase of ALT and subsequent reduction (P=0.043). The count of platelets increased in 4/5 patients. No effect on viral load was found. Conclusion: The therapeutic regime is well tolerated, no severe adverse events were documented. An improvement of the disease severity and liver inflammation were observed, with no effect on the viral load. We found reduction of IP-10 levels at month 12 -a sign of immune competence restoration.

Biochemical study on immunomodulation and safety margin of inosine acedoben dimepranol before and after vaccination

“…Our findings of survival or protection could be explained on the basis of the significant decrements of NDV titer in IAD only, Vaccine only and IAD + Vaccine groups comparing with control group indicated by PCR. Despite absence of similar findings in chickens, yet decreasing other virus titers by Isoprinosine may be supportive findings of the present study; for instance, [15] and [16] found that treatment with Isoprinosine decreased HB and HC virus titers, respectively.…”

Inosine Pranobex: A Key Player in the Game Against a Wide Range of Viral Infections and Non-Infectious Diseases

“…Immunomodulation therapy for patients with hepatitis C virus infection has been addressed only in individual cases or small groups of people [84, 85]. Use of IP, as monotherapy or in combination with ribavirin, had no impact on viral load.…”

“…However, normalization of alanine aminotransferase levels was observed in patients non-responsive to IFN treatment [85]. In addition, concomitant use of IP with ribavirin improved disease severity and liver inflammation, evidenced by a reduction in the levels of the IFN-γ-inducible protein 10 [84]. If similar results are obtained in the future in controlled studies with larger numbers of patients, the beneficial role of IP, especially in the case of patients non-responsive to mainstay treatments, could be established.…”

Rapid effect of one-day Isoprinosine intake on cytokine production in patients with chronic hepatitis B and healthy probands

“…Antiviral and immunomodulating activities of Isoprinosine were recently demonstrated in children with cellular immunodeficiency as a prophylaxis of recurrent viral infections (3). Previous studies discussed also its possible role in the treatment of chronic hepatitis B and C (1,(4)(5)(6), including the prevention of hepatic flare after discontinuation of lamivudine (7). (8).…”