High-dose vitamin E supplementation does not diminish ribavirin-associated haemolysis in hepatitis C treatment with combination standard alpha-interferon and ribavirin.
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.
Saeian
K
K
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ksaeian@mcw.edu
Bajaj
J S
JS
Franco
J
J
Knox
J F
JF
Daniel
J
J
Peine
C
C
McKee
D
D
Varma
R R
RR
Ho
S
S
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*
D000975:Antioxidants; D000998:Antiviral Agents; D014810:Vitamin E; D012254:Ribavirin