Effect Of Different Doses Of Silymarin In Chronic Hepatitis C Patients

Hepatitis C virus infects over 180 million people worldwide and is a major cause of liver disease. Current standard of care therapy with pegylated IFN and ribavirin cures about 50% of all patients. The US Food and Drug Administration (FDA) approval of the hepatitis C virus (HCV) NS3/4A protease inhibitors boceprevir and telaprevir has led to a major change in the standard of care for patients chronically infected with genotype 1 HCV.Objectives: To study the effect of different doses of silymarin in chronic hepatitis C patients as regard to tolerability, side effects and benefits of silymarin in Egyptian patients with chronic hepatitis C in damietta.Methods: This prospective study was conducted on 50 adult Egyptian chronic hepatitis C virus infected patients with compensated liver functions (Child A), attending to Damietta Cardiology and Gastroenterology Center. Patients are classified into 4 groups, Group I: 10 patients treated with placebo drug (vit B.complex), GroupII: 10 patient received half the usual dose of silymarin act as control group(210mg/day), GroupIII: 10 patients received the usual dose of silymarin every 8 hours (420mg/day), GroupIV: 20 patients received double the usual dose of silymarin every 8 hours (840mg/day).Results: A statistically significant negative relationship reported between the AST levels in the second and fourth month of follow up and the Silymarin dose received by the patients with r=-0.399 & -0.596 and p-value of 0.01 & 0.00 respectively but this relationship becomes insignificant on the sixth month where r=-0.159 & p-value=0.32. The same goes for ALT with r=-0.38, -0.567 and p-value of 0.015 & 0.00 for the second and fourth month respectively. Indicating that increasing doses of Silymarin over time up to a certain level has a significant effect on decreasing the liver enzymes levels after which the increasing doses of Silymarin doesn’t have any significant effect on the liver enzymes levels. Regarding the CBC results there was no reported significant influence of different doses of Silymarin on the level of Hemoglobin, total leucocytic count or platelets count throughout the follow up period till the end of the study.Conclusion: HCV RNA viral load levels is not influenced by different doses of Silymarin. Both AST & ALT levels significantly improves among the follow up periods of all groups. Increasing doses of Silymarin over time up to a certain level has a significant effect on decreasing the liver enzymes levels after which the increasing doses of Silymarin doesn’t have any significant effect on the liver enzymes levels. The frequency of adverse events reported by individual patients did not differ significantly among the different doses of Silymarin.