hypericum and Hepatitis-C

More than one-third of Americans use herbs for health purposes, yet patients and physicians usually lack accurate information about safety and efficacy of herbal remedies. In recent years, there has been a substantial increase in the use of so-called complementary and alternative therapies by patients with liver disease. Medical professionals and laboratorians need to be informed about popular alternative therapies and be open-minded to the possibility that some benefit may come from some therapies currently regarded as alternative. Silymarin extracted from the milk thistle is most widely subscribed to as a remedy for liver diseases. The beneficial effects of silymarin are most often seen in the patients who had cirrhosis as a result of alcohol abuse. An ongoing clinical trial will provide some insight as to whether milk thistle directly affects HCV. Silymarin has a good safety record and only rare case reports of gastrointestinal disturbances and allergic skin rashes have been published. The active component of licorice root, glycyrrhizin, has been shown to reduce alanine transaminase and aspartate transaminase values in the serum. This protective function has recently been explained as the inhibitory effects of glycyrrhizin on immune-mediated cytotoxicity against hepatocytes and on nuclear factor (NF)-kappa B, which activates genes encoding inflammatory cytokines in the liver. Finally, some patients with hepatitis C take St. John's Wort and ginger to treat the side effects caused by interferon therapy. An excellent review of this subject was recently published by the NCCAM.

Topics: Complementary Therapies; Glycyrrhiza; Hepatitis C; Humans; Hypericum; Phytotherapy; Silybum marianum; Zingiber officinale

Topics: Adult; Female; Hepatitis C; Humans; Hypericum; Liver Function Tests; Male; Photosensitivity Disorders; Phytotherapy; Plant Extracts; Plants, Medicinal; Viral Load

Meta-analyses sometimes summarize results in the presence of substantial unexplained between-study heterogeneity. As GRADE criteria highlight, unexplained heterogeneity reduces certainty in the evidence, resulting in limited confidence in average effect estimates. The aim of this paper is to provide a new clinically useful approach to estimating an intervention effect in light of unexplained heterogeneity.. We used a random-effects model to estimate the distribution of an intervention-effect across various groups of patients given data derived from meta-analysis. The model provides a distribution of the probabilities of various possible effects in a new group of patients. We examined how our method influenced the conclusions of two meta-analyses.. In one example, our method illustrated that evidence from a meta-analysis did not support authors' highly publicized conclusion that hypericum is as effective as other antidepressants. In the second example, our method provided insight into a subgroup analysis of the effect of ribavirin in hepatitis C, demonstrating clear important benefit in one subgroup but not in others.. Analysing the distribution of an intervention-effect in random-effects models may enable clinicians to improve their understanding of the probability of particular-intervention effects in a new population.

Topics: Antidepressive Agents; Data Interpretation, Statistical; Depression; Hepatitis C; Humans; Hypericum; Meta-Analysis as Topic; Models, Statistical; Plant Extracts; Ribavirin; Treatment Outcome

Topics: Antiviral Agents; Contraceptives, Oral; Drug Interactions; Female; Hepatitis C; Herb-Drug Interactions; Humans; Hypericum; Interferons; Male; Plants, Medicinal; Pregnancy

Topics: Antidepressive Agents; Asthma; Continuity of Patient Care; Family Practice; Hepatitis C; Humans; Hypericum; Osteoporosis; Perylene; Physician-Patient Relations; Plants, Medicinal; Quercetin; United States; Xanthenes