Medicinal herbs for hepatitis C virus infection: a Cochrane hepatobiliary systematic review of randomized trials.
OBJECTIVE
The aim of this study was to assess beneficial and harmful effects of medicinal herbs for hepatitis C virus (HCV) infection.


METHODS
The databases of the Cochrane Collaboration, MEDLINE, EMBASE, and BIOSIS were searched combined with manual searches of five Chinese and one Japanese journals. We included randomized trials comparing medicinal herbs with placebo, no intervention, nonspecific treatment, other herbs, or interferon and/or ribavirin. Trials of herbs with or without other drug(s) were included. Methodological quality of the trials was evaluated by randomization, double blinding, and the Jadad scale.


RESULTS
Thirteen randomized trials (n = 818) evaluated 14 medicinal herbs. Four trials had adequate methodology. Compared with placebo, none of the herbs showed effects on HCV RNA or liver enzyme, except for silybin, which showed a significant reduction of serum AST and gamma-glutamyltranspeptidase levels in one trial. Oxymatrine showed effects on clearance of HCV RNA (relative risk = 9.20, 95% CI = 1.26-67.35) compared with vitamins. The herbal mixture Bing Gan Tang plus interferon-alpha showed better effects on clearance of HCV RNA (relative risk = 2.54, 95% CI = 1.43-4.49) and on normalization of serum ALT (relative risk = 2.54, 95% CI = 1.43-4.49) than interferon-alpha alone. The herbal mixture Yi Zhu decoction showed better effects on clearance of HCV RNA and normalization of ALT compared with glycyrrhizin plus ribavirin. Yi Er Gan Tang showed effects on normalizing serum ALT compared with silymarin plus glucurolactone. The herbs were associated with adverse events.


CONCLUSIONS
There is no firm evidence supporting medicinal herbs for HCV infection, and further randomized trials are justified.
Liu
Jianping
J
The Cochrane Hepatobiliary Group, Copenhagen Trial Unit, Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.
Manheimer
Eric
E
Tsutani
Kiichiro
K
Gluud
Christian
C
D016174:Hepacivirus / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000201:enzymology / Q000821:virology*; D010936:Plant Extracts / Q000627:therapeutic use*; D010946:Plants, Medicinal; D012367:RNA, Viral / Q000302:isolation & purification; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D010936:Plant Extracts; D012367:RNA, Viral