Oral prostaglandin (PGE2) therapy for chronic viral hepatitis B and C.
The cytoprotective effects of prostaglandins have been utilized in the prevention of hepatitis B virus reactivation after liver transplantation. This pilot study evaluated the effects of oral prostaglandin E2 (PGE2) in chronic viral hepatitis B and C. Twenty patients with chronic hepatitis B and 20 patients with chronic hepatitis C received 4mg day-1 PGE2 for 6 months. The lymphocyte antiviral enzyme 2',5'-oligoadenylate synthetase (2',5'-OAS) and peripheral blood monocyte procoagulant activity (PCA) were measured before, during and after the treatment. Three of 20 hepatitis B and five of 20 hepatitis C patients withdrew from the study. Eight of 17 hepatitis B patients responded: in seven of these eight patients, serum alanine aminotransferase (ALT) levels normalized; loss of viral replication was sustained in all eight patients; and seroconversion from hepatitis Be antigen (HBeAg) to hepatitis Be antibody (HBeAb) positivity occurred in seven patients over the 48-week duration of this study. In 14 of the 15 hepatitis C patients, hepatitis C virus (HCV) RNA remained detectable and the serum ALT levels remained elevated. 2',5'-OAS levels and PCA values did not correlate with other markers of response to PGE2 therapy in either chronic hepatitis B or C. In summary, PGE2 was associated with sustained loss of viral replication in 47% of chronic hepatitis B patients; no beneficial effects were apparent in chronic hepatitis C.
Hyman
A
A
Department of Medicine, University of Toronto, Canada.
Yim
C
C
Krajden
M
M
Read
S
S
Basinski
A S
AS
Wanless
I
I
Levy
G
G
Heathcote
J
J
D015088:2',5'-Oligoadenylate Synthetase / Q000097:blood; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001777:Blood Coagulation; D004279:DNA, Viral / Q000097:blood; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008214:Lymphocytes / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000502:physiology; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome
D004279:DNA, Viral; D012367:RNA, Viral; D000410:Alanine Transaminase; D015088:2',5'-Oligoadenylate Synthetase; D015232:Dinoprostone