Eicosapentaenoic Acid Supplementation for Chronic Hepatitis C Patients During Combination Therapy of Pegylated Interferon α‐2b and Ribavirin

Abstract

Eicosapentaenoic acid (EPA) (1.8 g/day) was administered to 12 chronic hepatitis C patients receiving combination therapy of pegylated interferon (PEG-IFN) alpha-2b and ribavirin for 48 weeks (EPA group). Twelve patients were not administered EPA (control group). All patients also received vitamin E and C (300, 600 mg/day, respectively) during the therapy. Serum alanine aminotransferase improved to a normal level in 8 of 12 patients from the EPA group and 6 of 12 patients from the control group after 12 weeks. Lymphocyte counts decreased significantly after 8 weeks in the control group, but not the EPA group. T-helper (Th) 1 decreased after 4 weeks in the control group, but not in the EPA group (two-way ANOVA; P < 0.05). Th1/Th2 ratios were elevated in 9 of 12 patients in the EPA group, and 3 out of 12 in the control group (P < 0.05) after 8 weeks. After 12 weeks, the arachidonic acid/EPA molar ratio of erythrocyte membrane phospholipid correlated negatively with the leukocyte count (n = 24, r = -0.439, P < 0.05) and the neutrophil count (n = 24, r = -0.671, P < 0.02). The hemoglobin level improved after 48 weeks compared with 24 weeks in only the EPA group. These findings suggest that EPA supplementation may be useful in therapy for chronic hepatitis C.

Mitochondrial Free Radicals, Antioxidants, Nutrient Substances, and Chronic Hepatitis C

“…These patients had clearly lower plasma and serum 8-oxo-dG levels after six-months of treatment with IFN-a, ribavirin, and antioxidants (300 mg a-tocopherol/day and 600 mg ascorbic acid/day). EPA supplementation also decreased the ratio of AA to EPA and increased leukocyte levels (Tomioka et al, 2005;Kawashima et al, 2008); suggesting treatment with EPA prevents AA accumulation. Thus, these observations suggest that the combination of EPA and antioxidants (vitamin C and vitamin E) may ameliorate inflammation and oxidative stress and thereby increase the response of antiviral therapy in HCV-infected patients.…”

Modulatory Potentials of n-3 Polyunsaturated Fatty Acids in Inflammatory Diseases

“…Some of the other adverse effects of RBV treatment which have been effectively countered by n-3 PUFA include lowering of the impairment of the filterability of erythrocytes of chronic HCV patients in whom erythrocyte filterability was caused due to oxidative membrane damage induced by RBV which led to hemolytic anemia [86]. This finding further ensures the maintenance of the lymphocyte levels and improvement in hemoglobin levels in the patients of PEG-IFN and RBV treatment [87]. Thus, n-3 PUFA and their mediators can be recommended for concurrent administration with the recommended standard interferon and antibiotic therapy, to facilitate recovery, ameliorate adverse effects, and prevent mortalities in chronic cases.…”

Prophylaxis for ribavirin‐related anemia using eicosapentaenoic acid in chronic hepatitis C patients

“…During the last decade, eicosapentaenoic acid (EPA) supplementation was shown to be an effective treatment for ribavirin‐related anemia in adult patients 9–12 . EPA is widely used to treat hyperlipidemia and atherosclerosis with no severe side‐effects.…”