The Effect Of Antioxidants On The Side Effects Of Pegylated Interferon/Ribavirin Combination Therapy In Patients With Chronic Hepatitis C

Hepatitis C virus (HCV) is one of the main causative agents of chronic viral hepatitis. According to WHO, Egypt has a very high prevalence of CHC which may exceed 20% of Egyptian population. Combination therapy with pegylated interferon and ribavirin has been recommended as a standard therapy for patients with chronic hepatitis C. Unfortunately, this combination therapy is associated with numerous side effects that affect both patients’ compliance and response rates. Side effects of CHC treatment with Pegylated interferon and Ribavirin are believed to be, in part, due to oxidative stress induced by Ribavirin. In the present work, we tried to evaluate if antioxidants can ameliorate the side effects profile in patients with CHC treated by combination therapy.This is a randomized controlled study. 200 patients were selected and randomly divided into 2 groups.Group I (study group): 100 patients under combination therapy (Peginterferon and Ribavirin) and receiving in addition antioxidants (vitamin C retard 500 mg daily, vitamin E 400 mg daily, silymarin 420 mg daily and N-acetylcystein 600 mg daily) for 48 weeks.Group II (control group): 100 patients under combination therapy (Peginterferon and Ribavirin) alone for 48 weeks.This study concluded that the use of this mixture of antioxidants (vitamin C retard 500 mg daily, vitamin E 400 mg daily, silymarin 420 mg daily and N-acetylcystein 600 mg daily) with antiviral combination therapy in patients with CHC can improve treatment associated anemia and fatigue but has no effect on other treatment associated side effects. These results can improve the quality of life and adherence to therapy and this can justify the use of these antioxidants as an adjunctive therapy with pegylated interferon and ribavirin.