scholarly journals Effectiveness and safety of orally administered silymarin (milk thistle) for pegylated interferon unresponsive chronic delta hepatitis patients

2021 ◽  
Vol 8 (7) ◽  
pp. 428-431
Author(s):  
Mesut Aydin ◽  
Erhan Ergin ◽  
Elif Tugba Tuncel ◽  
Yaren Dirik ◽  
Suat Ozluk ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Treatment Success ◽  
Sustained Viral Response ◽  
Pegylated Interferon ◽  
Decompensated Cirrhosis ◽  
Milk Thistle ◽  
Hepatitis C Infection ◽  
Hepatitis D ◽  
End Of Treatment ◽  
Hdv Infection

Objective: Silymarin is a natural extract from milk thistle (Silybum marianum), a natural herb that contains flavonoids. Silymarin also has anti-inflammatory properties and lipid peroxidation effects on human hepatocytes. It has also been used for the treatment of acute alpha-amanitin poisoning and chronic hepatitis C infection.  Chronic Hepatitis D virus (HDV) infection is a severe health problem leading to fibrosis and hepatocellular carcinoma. Patients with chronic HDV infection can be treated with Peg-IFN with lower treatment success.  Most patients with chronic HDV are unable or unwilling to use interferon (IFN)-based treatment due to liver cirrhosis. Our objective was to establish the long-term clinical outcomes with silymarin for interferon-experienced chronic HDV patients. Materials and Methods: We studied ten patients from one centre with interferon who experienced chronic HDV, of which 8 had cirrhosis, and 2 had chronic hepatitis who received HDV treatment with silymarin 600 mg/day after a median period of 12 months. Information collected included demographic, clinical, virologic, and outcomes data. MELD and Child-Pugh (CP) scores were also obtained. Friedman test was used to evaluate the laboratory parameters during the study period. Results: 10 chronic HDV patients (median age 54 yrs, six female, all of them previous null responders to Peg-IFN  with mildly decompensated cirrhosis [CP 7 (range 6-11), MELD 11 (range 6-20] were followed for 12 months from the start of silymarin 600 mg/day. There was no decompensation of both MELD and CP scores among patients at the end of therapy. In addition, no patients stopped silymarin treatment early due to side effects. At the end of treatment, there was no significant change in prothrombin time (p= 0.949), AST (p=0.662) and AFP (p=0.983) levels and platelets counts (p=0.988) compared to the pre-treatment period (all p>0.005). Finally, HDV-RNA suppression was seen in all patients at the end of treatment (p=0.009). Conclusions: In the light of the presented data, silymarin seems to be effective in treating chronic HDV infection. Further research is needed for validation. The study is ongoing with a collection of data on sustained viral response.

Sofosbuvir plus Daclatasvir without Ribavirin for the Treatment of Chronic Hepatitis C in Patients with Decompensated Liver Disease

2020 ◽  
Vol 14 (1) ◽  
pp. 41-44
Author(s):  
Mahmood Ahmad ◽  
Muhammad Ayub ◽  
Fawad Iqbal Janjua ◽  
Abdul Moiz Bhatti ◽  
Nooman Gilani
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Treatment Success ◽  
Virologic Response ◽  
Decompensated Cirrhosis ◽  
Hepatitis C Infection ◽  
Hepatic Decompensation ◽  
Decompensated Liver Disease

ABSTRACT Background: In chronic hepatitis C infection, hepatic decompensation remained a contraindication to treatment for many years. The direct acting antiviral drugs have shown high treatment success even in decompensated liver disease. This study aims to assess the response and safety profile of Sofosbuvir and Daclatasvir in patients of decompensated cirrhosis with chronic hepatitis C. Patients and Methods: It was a prospective observational study conducted at Gastroenterology Department of Gujranwala Medical College/ DHQ teaching Hospital, Gujranwala from February 2016 to December 2017.Consecutive patients of hepatitis C with decompensated cirrhosis were enrolled in the study. Sofosbuvir 400mg and Daclatasvir 60mg was given to all patients without ribavirin for a period of 24 weeks. Sustained virologic was taken as primary end point. Results: A total of 140 patients were included in our study, 122 patients (87%) completed the study, 08 patients (5.7%) were lost to follow up, treatment discontinuation was seen in 06 patients (4.2%) & 04 patients (2.8%) died during the study. 110 patients (90.2%) achieved end treatment response (ETR), 12 patients (9.8%) remained treatment non-responder, 100 patients (82%) achieved sustained virological response (SVR12) and 10 patients (8%) had a relapse of HCV infection. Conclusion: Once daily oral Sofosbuvir plus Daclatasvir without Ribavirin achieved overall high rates of sustained virologic response in patients with chronic HCV having decompensated liver disease.

Chronic Hepatitis D Virus (HDV) Infection in Hepatitis B Virus Carrier Chimpanzees Experimentally Superinfected with HDV

1988 ◽  
Vol 158 (1) ◽  
pp. 151-159 ◽  
Author(s):  
F. Negro ◽  
K. F. Bergmann ◽  
B. M. Baroudy ◽  
W. C. Satterfield ◽  
H. Popper ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hepatitis D ◽  
Hepatitis D Virus ◽  
B Virus ◽  
Hepatitis B Virus Carrier ◽  
Hdv Infection ◽  
Virus Carrier

scholarly journals Response to combination of sofosbuvir and daclatasvir in chronic hepatitis C infection.

2020 ◽  
Vol 27 (12) ◽  
pp. 2596-2600
Author(s):  
Irfan Ahmad ◽  
Muhammad Israr ul Haq ◽  
Ghulam Abbas
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Treatment Response ◽  
Chronic Hepatitis C ◽  
Hepatitis C Infection ◽  
Open Label ◽  
College Hospital ◽  
End Of Treatment ◽  
Significant Difference ◽  
Chronic Hepatitis C Patients

Objectives: To determine efficacy of sofosbuvir and daclatasvir in the treatment of chronic hepatitis C infection. Study Design: Open label uncontrolled interventional study. Setting: Hepatitis Clinic, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Period: June to December 2018. Material & Methods: Five hundred treatment naïve chronic hepatitis C patients including those with compensated cirrhosis were included in the study. They were given sofosbuvir 400 mg daily and daclatasvir 60 mg daily. Weight based ribavirin was added if patient has evidence of cirrhosis. Treatment duration was 12 weeks for non-cirrhotic and 24 weeks for cirrhotics. End of treatment response (ETR) was recorded. Results: Mean age of the included patients was 41±11.69 with range from 8 to 82 years, while 217 (43.4 %) patients were male and 283 (56.6 %) were female. Cirrhosis was present in 59 (11.8 %) patients; among these 35.6 % were in Child A and 64.4 % in early Child B. End of treatment response occurred in 491 (98.2 %) patients and there was no significant difference in ETR between male and female patients, and between cirrhotic and non-cirrhotic. Similarly, there was no significant difference in age between those having ETR and those having no ETR. Fatigue was experienced by 13.2 % and headache by 4.2 % patients. Conclusion: The combination of sofosbuvir and daclatasvir has high response rate in chronic hepatitis C patients of our population.

Equally Poor Outcomes to Pegylated Interferon-based Therapy in African Americans and Hispanics With Chronic Hepatitis C Infection

2010 ◽  
Vol 44 (2) ◽  
pp. 140-145 ◽  
Author(s):  
Sanjaya K. Satapathy ◽  
Chandra Sekhar Lingisetty ◽  
Shawnette Proper ◽  
Shobhana Chaudhari ◽  
Susan Williams
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
African Americans ◽  
Chronic Hepatitis C ◽  
Pegylated Interferon ◽  
Hepatitis C Infection ◽  
Poor Outcomes

scholarly journals An update on the management of chronic hepatitis D

2019 ◽  
Vol 7 (6) ◽  
pp. 396-402 ◽  
Author(s):  
Pir Ahmad Shah ◽  
Saad Choudhry ◽  
Karen J Campoverde Reyes ◽  
Daryl T Y Lau
Keyword(s):  
Chronic Hepatitis ◽  
Antiviral Agents ◽  
Therapeutic Agents ◽  
Clinical Development ◽  
Severe Liver ◽  
Hepatitis D ◽  
Diagnostic Assays ◽  
Enhanced Sensitivity ◽  
At Risk Populations ◽  
Hdv Infection

Abstract Hepatitis D virus (HDV) infection is associated with severe liver-related morbidity and mortality. The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas. Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations. Until recently, interferon has been the only treatment for hepatitis D. Its efficacy is, however, limited and it is associated with significant side effects. A number of novel antiviral agents that target various stages of the HDV life cycle show promising results. They are currently in different phases of clinical development. This review focuses on the changing epidemiology, novel therapeutic agents, and updated management of chronic hepatitis delta.

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