Treatment of chronic hepatitis B with high-dose intravenous N-acetyl-L-cysteine.
OBJECTIVE
Therapy of hepatitis B with alpha-interferon is only successful in 30-40%; therefore new therapeutic options are needed. N-acetyl-L-cysteine is well known as an antidote against paracetamol intoxication and as mucolytic agent in pulmonary diseases. Furthermore, it restrains human immunodeficiency virus replication and inhibits hepatitis B virus replication at a posttranscriptional level in vitro. This study aims to evaluate the efficacy of N-acetyl-L-cysteine in 5 patients chronically infected with hepatitis B virus.


METHODS
N-acetyl-L-cysteine was given intravenously at a daily dose of 150 mg/kg body weight. Treatment was performed for 28 days.


RESULTS
The N-acetyl-L-cysteine infusions were tolerated without any side effects. Except a mild increase in thrombocyte-counts within the last week of N-acetyl-L-cysteine infusion blood tests did not change. We could not detect any changes in quantitative hepatitis B virus-DNA levels as well as in the HBeAg-status.


CONCLUSIONS
We conclude from our data that N-acetyl-L-cysteine given in a high dose intravenously for 28 days is well tolerated. In contrast to in vitro studies no significant effects on the hepatitis B-virus load were detectable in vivo.
Weidenbach
Hans
H
Department of Gastroenterology, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany. hans.weidenbach@medizin.uni-ulm.de
Orth
Martina
M
Adler
Guido
G
Mertens
Thomas
T
Schmid
Roland M
RM
D000111:Acetylcysteine / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004279:DNA, Viral / Q000097:blood; D004305:Dose-Response Relationship, Drug; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007262:Infusions, Intravenous; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D014779:Virus Replication / Q000187:drug effects
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000111:Acetylcysteine