Herbal products, used for centuries in Far Eastern countries, are gaining popularity in western countries.
Surveys indicate that persons with chronic Hepatitis C often use herbals, especially silymarin, a milk thistle extract.
This is taken in the hope of improving the modest response to antiviral therapy and reduce side effects.
|Silymarin constituted 72% of 60 herbals used at enrollment|
Dr Leonard Seeff and colleagues evaluated patients in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial.
The patients were nonresponders to prior antiviral therapy, but still willing to participate in long-term pegylated interferon treatment.
The team examined the use and potential effects of silymarin.
The team found among 1145 study participants, 56% had never taken herbals, 21% admitted past use, and 23% were using them at enrollment.
Silymarin constituted 72% of 60 herbals used at enrollment.
The team found among all participants, 67% had never used silymarin, 16% used it in the past, and 17% used it at baseline.
Silymarin use varied widely among the 10 participating study centers.
The team noted that men were more frequent users than women, as were non-Hispanic whites than African Americans and Hispanics.
Silymarin use correlated strongly with higher education.
No beneficial effect of silymarin was found on serum alanine aminotransferase or Hepatitis C virus RNA levels.
The team used univariate analysis, and identified significantly fewer liver-related symptoms and better quality-of-life parameters in users than nonusers.
The research team then reanalyzed the findings, and adjusted for covariates of age, race, education, alcohol consumption, exercise, body mass index, and smoking.
After this adjustment, the researchers noted that only fatigue, nausea, liver pain, anorexia, muscle and joint pain, and general health remained significantly better in silymarin users.
Dr Seeff's team concluded, "Silymarin users had similar alanine aminotransferase and Hepatitis C virus levels to those of nonusers but fewer symptoms and somewhat better quality-of-life indices."
"Its use among these Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis participants was self-motivated and uncontrolled."
"However, only a well-designed prospective study can determine whether silymarin provides benefit to persons with chronic Hepatitis C."