Bile acid may help treat hepatitis C patients

A bile acid — called ursodeoxycholic acid — may improve response to treatment in chronic hepatitis C virus (HCV) patients who do not respond to standard therapy with interferon and ribavirin. Ursodeoxycholic acid is a secondary bile acid that breaks down fat, and reduces the amount of cholesterol produced by the liver and absorbed by the intestines. It also helps in breaking down cholesterol that has formed into gallstones and increases bile flow in patients with primary biliary cirrhosis. Ursodeoxycholic acid therapy, which reduces levels of a type of enzyme (aminotransferase), may slow the progression of liver fibrosis and prevent the development of liver cancer. To investigate whether the addition of ursodeoxycholic acid can improve treatment results, researchers from the University of Tokyo Graduate School of Medicine studied 596 patients who had elevated levels of the liver enzyme alanine aminotransferase (ALT). The patients were randomly assigned to receive one of the three daily doses of ursodeoxycholic acid for 24 weeks. ALT, as well as two additional liver enzymes, aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT), decreased at the fourth week, and then remained constant during drug administration. Changes in ALT and AST did not differ in the patients who received the two higher doses — 600 milligrams (mg) or 900 mg — but GGT was significantly lower in the 900 mg group. In patients with initial GGT levels exceeding 80 IU/L who received 900 mg, ALT also showed a significant decrease. However, there was no change in blood levels of HCV in any of the groups. Overall, 19 per cent of the patients reported adverse effects, but there were no differences in adverse effects among three groups. However, further research is warranted before advising ursodeoxycholic acid treatment in hepatitis C.