Effect of ursodeoxycholic acid administration in patients with acute viral hepatitis: a pilot study.
BACKGROUND
Ursodeoxycholic acid (UDCA) is able to improve biochemical markers of cholestasis, with a parallel decrease in transaminases, in various cholestatic liver diseases.


OBJECTIVE
To evaluate the effects of UDCA administration on acute viral hepatitis-related cholestasis and the course of acute viral hepatitis.


METHODS
Seventy-nine consecutive patients with acute viral hepatitis (HBV: 43, HCV: 11, HAV: 15, HEV: 3, Non A-E: 7) were randomized to receive either UDCA for 3 weeks or no treatment. Liver biochemistry and serum bile acid determinations were run at weekly intervals.


RESULTS
No significant differences were observed in mean percentage decreases in transaminases between treated and untreated patients. By contrast, cholestatic indexes decreased significantly more quickly in patients treated with UDCA than in controls, and this effect was more evident in patients with increasing alanine transaminase levels at admission. After a peak at the end of the first week of therapy, serum levels of conjugated ursodeoxycholic acid (CUDCA) showed a gradual decrease. Conjugated cholic acid (CCA) and chenodeoxycholic acid (CCDCA) showed a progressive decrease with the resolution of viral hepatitis, but no influence of UDCA administration was observed.


CONCLUSIONS
Our study demonstrates that UDCA significantly improves cholestatic indices in patients with acute viral hepatitis, but this effect does not seem to affect the course of the illness.
Fabris
P
P
Department of Infectious Diseases, S. Bortolo Hospital, Vicenza, Italy. fabris.p@medicivi.org
Tositti
G
G
Mazzella
G
G
Zanetti
A R
AR
Nicolin
R
R
Pellizzer
G
G
Benedetti
P
P
de Lalla
F
F
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002635:Chenodeoxycholic Acid / Q000097:blood; D002756:Cholagogues and Choleretics / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D002779:Cholestasis / Q000188:drug therapy* / Q000209:etiology; D019826:Cholic Acid / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000097:blood; D006518:Hepatitis Viruses / Q000235:genetics / Q000276:immunology; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D006508:Hepatitis Antibodies; D012367:RNA, Viral; D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid; D019826:Cholic Acid