Vitamin E in the Treatment of Chronic HB
Vitamin E in the Treatment of Chronic HB
August 1998; Volume 1: 95
Source: Andreone P, et al. Vitamin E for chronic hepatitis B. Ann Intern Med 1998;128:156-157.
To evaluate the effect of vitamin E supplementation as therapy for chronic hepatitis B, 24 patients (12 positive for hepatitis B e antigen [HbeAg] and 12 infected by the "e" minus mutant) were randomly assigned by investigators to receive vitamin E, 300 mg twice daily for three months, or no treatment.
Biochemical and virologic outcomes were assessed at three and nine months. After nine months, seven of the 12 patients treated with vitamin E achieved normalization of serum alanine aminotransferase (ALT) levels; only one of the 12 controls did. Five of the seven responders also became negative for hepatitis B DNA; of these five, three positive for HBeAg seroconverted to hepatitis B e antibody (HBeAb). Four patients taking vitamin E discontinued it because of more than 10-fold increases in ALT levels; two controls also had these increases.
The researchers concluded that, ". . . vitamin E is a safe and useful treatment for chronic hepatitis B."
COMMENT
Vitamin E seems to be for just about everything-it is the new vitamin C. Vitamin E certainly does have some confirmed, evidence-based effects: it seems as good as selegiline for the early memory problems of dementia; it reduces risk for coronary disease in men and women; and it seems to reduce the risk for prostate cancer and for cataracts.
The drawbacks? It may increase the risk of hemorrhagic stroke and may increase anticoagulation. And, you can't get 100-800 IU daily on a low fat diet!
Can vitamin E treat chronic hepatitis safely and effectively? Chronic hepatitis B is such a serious disease-infecting 300,000 Americans annually-that any agent or practice that is relatively benign seems worth a try. There are several common sense measures: eating a very low protein (50 g daily), low fat diet; choosing drugs metabolized by the kidney rather than liver; abstaining from alcohol; and avoiding exposure to chemical pesticides, herbicides, fungicides, and other toxins metabolized by the liver.
These authors from the University of Bologna note that interferon alpha had "failed" in 19 of the 24 enrollees. The dosage, schedule, route of administration, and protocol for interferon administration was not recounted, but it is often expensive and difficult to follow. A recent report of a one-year Asian trial of lamivudine, an oral nucleoside analogue, reduced liver necrosis and had fewer side effects than are typically reported for interferon.
Conclusion
Vitamin E supplementation appears to cause changes in HBeAg and HBeAb status and ALT levels in some patients with chronic hepatitis B. Levels should be monitored at least monthly for those patients who choose to take vitamin E outside of an experimental protocol. A larger trial with long-term follow-up would be extremely useful.
August 1998; Volume 1: 95Subscribe Now for Access
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