Medicinal herbs for hepatitis C virus infection

Abstract

BackgroundHepatitis C virus (HCV) infection is a serious health problem world-wide. Medicinal herbs are increasingly being used for hepatitis C. ObjectivesTo assess the efficacy and safety of medicinal herbs for hepatitis C virus infection. Search methodsSearches were applied to The Controlled Trial Registers of The Cochrane Hepato-Biliary Group, The Cochrane Complementary Medicine Field, and The Cochrane Library as well as MEDLINE, EMBASE, BIOSIS, Chinese and Japanese databases (February 2001). Five Chinese and one Japanese journals were handsearched. No language restriction was used. Selection criteriaRandomised clinical trials comparing medicinal herbs versus placebo, no intervention, general non-specific treatment, other herbal medicine, or interferon and/or ribavirin treatment. Trials of medicinal herbs plus interferon and/or ribavirin versus interferon and/or ribavirin alone were also included. Data collection and analysisTwo authors extracted data independently. The methodological quality of the trials was evaluated using the generation of allocation sequence, allocation concealment, double blinding, and the Jadad-scale. The outcomes were presented as relative risk or weighted mean difference, both with 95% confidence interval. Main resultsTen randomised trials, including 517 patients with mainly chronic hepatitis C, evaluated ten different medicinal herbs versus various control interventions (four placebo, four interferon, two other herbs). The methodological quality was considered adequate in four trials and inadequate in six trials. Compared with placebo in four trials, none of the medicinal herbs showed positive effects on clearance of serum HCV RNA or anti-HCV antibody or on serum liver enzymes, except one short-term trial in which a silybin preparation showed a significant effect on reducing serum aspartate aminotransferase and gamma-glutamyltranspeptidase activities. The herbal compound Bing Gan Tang combined with interferon-alpha showed significantly better effects on clearance of serum HCV RNA (relative risk

Understudied populations with hepatitis C

“…27 Most studies of CAM therapy have been hampered by the small numbers of patients evaluated, the inclusion of patients with varying forms of hepatitis, and the lack of randomization or placebo controls. 19,28 Prospective, adequately powered, randomized, controlled trials of potentially effective herbal medications are needed.…”

Antioxidant and antiviral activities of silybin fatty acid conjugates

“…Although the most preparations did not show positive effects on the clearance of serum HCV RNA or anti-HCV antibodies or on serum liver enzymes, silybin exhibited a significant effect, reducing serum aspartate aminotransferase and gamma-glutamyltranspeptidase activities [35,36]. The antiviral mechanism of silybin action is still unclear because its chemical and pharmacological properties may change when it is administered orally.…”

Antioxidant therapy for chronic hepatitis C after failure of interferon: Results of phase II randomized, double-blind placebo controlled clinical trial

“…In a recent study, 41% of patients reported use of these modalities, with 20% reporting use of herbal medicine, including sylamarin (12%), licorice root (glycyrrhizin) and St. John's wart [9] . In a review of medicinal herbs for HCV infection, the authors concluded that some of these agents may have an effect on liver enzymes but there is no firm evidence that supports their efficacy on chronic HCV [10] . In a recently published phase-I, open label clinical trial, 50 patients with chronic HCV infection were treated orally with a combination of seven antioxidative oral preparations (glycyrrhizin, schisandra, silymarin, ascorbic acid, lipoic acid, L-glutathione, and alpha-tocopherol) on a daily basis for 20 wk, along with four different intravenous preparations (glycyrrhizin, ascorbic acid, L-glutathione, B-complex) twice weekly for the first 10 wk [11] .…”