title: High-dose vitamin E supplementation does not diminish ribavirin-associated haemolysis in hepatitis C treatment with combination standard alpha-interferon and ribavirin.
abstract: BACKGROUND
  Ribavirin is associated with haemolytic anaemia. Antioxidants have been reported to decrease severity of this anaemia.
  
  
  OBJECTIVE
  To determine effect of vitamin E supplementation on ribavirin-associated haemolysis in chronic hepatitis C treated with standard alpha-interferon and ribavirin.
  
  
  METHODS
  Fifty-one naive chronic hepatitis C patients were randomized to receive either alpha-interferon/ribavirin therapy (control) or therapy plus vitamin E 800 IU b.d. with 24-week follow-up. Alanine aminotransferase ALT, haemoglobin and reticulocyte percentage were monitored. Symptoms and health-related quality of life were also monitored at each visit.
  
  
  RESULTS
  Forty-seven subjects were treated (27 vitamin E /20 controls). Thirteen withdrew because of adverse effects or non-compliance. Groups were similar in demographics, genotype and baseline lab indices. Comparison with baseline, treatment and follow-up values showed a significant haemoglobin and ALT reduction in both groups. There was no significant difference in haemoglobin and reticulocyte percentage between groups. Sustained viral response was not significantly different between vitamin E (11/18) and control (6/16) groups. Three patients required ribavirin dose-reduction in the vitamin E group compared with two controls. Health-related quality of life during and end-of-treatment was not different between groups.
  
  
  CONCLUSIONS
  Vitamin E supplementation alone during standard alpha-interferon and ribavirin therapy does not appear to diminish ribavirin-associated haemolysis.
authors.affiliation: Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ksaeian@mcw.edu
authors.forename: K
authors.initials: K
authors.lastname: Saeian
authors.forename: J S
authors.initials: JS
authors.lastname: Bajaj
authors.forename: J
authors.initials: J
authors.lastname: Franco
authors.forename: J F
authors.initials: JF
authors.lastname: Knox
authors.forename: J
authors.initials: J
authors.lastname: Daniel
authors.forename: C
authors.initials: C
authors.lastname: Peine
authors.forename: D
authors.initials: D
authors.lastname: McKee
authors.forename: R R
authors.initials: RR
authors.lastname: Varma
authors.forename: S
authors.initials: S
authors.lastname: Ho
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006461:Hemolysis / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011788:Quality of Life; D012254:Ribavirin / Q000008:administration & dosage*; D014810:Vitamin E / Q000008:administration & dosage*
chemical_list: D000975:Antioxidants; D000998:Antiviral Agents; D014810:Vitamin E; D012254:Ribavirin