Vitamin E as treatment for chronic hepatitis B: results of a randomized controlled pilot trial.
OBJECTIVE
Interferon-alpha treatment has been the treatment of choice for chronic hepatitis with unpredictable results. Recently, Lamivudine has been licensed for use against HBV infection with good results. Unfortunately, recurrence of viremia after lamivudine withdrawal is common and prolonged treatment can induce the emergence of resistant mutant strains. It has been shown that vitamin E can increase the host immune response, and this may provide protection against infectious diseases.


METHODS
We evaluated vitamin E supplementation as therapy for chronic hepatitis B in a pilot study including 32 patients. Patients were randomly allocated to receive vitamin E at the dose of 300 mg twice daily for 3 months (15 patients) or no treatment (17 patients). They were seen monthly during the first 3 months and thereafter quarterly for additional 12 months.


RESULTS
The two groups were comparable at enrollment. At the end of the study period, alanine aminotransferase (ALT) normalization was observed in 7 (47%) patients in vitamin E group and only in 1 (6%) of the controls (P=0.011); HBV-DNA negativization was observed in 8 (53%) patients in the vitamin E group as compared to 3 (18%) in the control group, respectively (P=0.039). A complete response (normal ALT and negative HBV-DNA) was obtained in 7 (47%) patients taking vitamin E and in none of the controls (P=0.0019).


CONCLUSIONS
Vitamin E supplementation might be effective in the treatment of chronic hepatitis B.
Semeiotica Medica, Dipartimento di Medicina Interna, Cardioangiologia ed Epatologia, Università di Bologna, Policlinico Sant'Orsola, Via Massarenti, 9, 40138, Bologna, Italy. andreone@med.unibo.it
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P
Andreone
S
S
Fiorino
C
C
Cursaro
A
A
Gramenzi
M
M
Margotti
L
L
Di Giammarino
M
M
Biselli
R
R
Miniero
G
G
Gasbarrini
M
M
Bernardi
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use*
D004279:DNA, Viral; D014810:Vitamin E; D000410:Alanine Transaminase