Ursodeoxycholic acid in the therapy of chronic hepatitis after treatment with interferon

UNLABELLED: Interferon alfa is to day the only therapy of proven benefit for the treatment and control of chronic hepatitis C. Therefore only 25% of patients receive from it a sustained biochemical and serological response; often when the treatment is stopped there is a flare up of ALT and reappearance of HCV-RNA in the serum. The most common schedule is 6 MU t.i w. for twelve months; after this there is no codified treatment for relapse prevention. The aim of this study was to evaluate if ursodeoxycholic acid (UDCA) administration after a cycle of IFN therapy was able to prevent relapse of the disease. METHODS: We studied 36 patients whose mean age was 31.5 +/- 5.7 affected by chronic hepatitis C and treated with IFN alpha for one year. Only twenty of them received an end term therapy response and were therefore enrolled in a double blind study with two arms: Arm A treated with UDCA 300 mg b. i. d. for twelve months and Arm B treated with placebo. ALT value and HVC-RNA levels were evaluated at baseline, during and after treatment. RESULTS: Patients treated with UDCA showed a lower percentage of relapse in comparison with patients treated with placebo. CONCLUSIONS: This effect was probably due to a double mechanism: the first of biochemical type because a reduction in the intrahepatic concentration of hydrophobic biliary acids, the second immunological due to a lower expression of HLA class I and II antigens.