EFFECT OF MISOPROSTOL ON THE COURSE OF VIRAL-HEPATITIS-B

Background/Aims: Some prostaglandins revealed hepatoprotective effects , that was confirmed mostly in experimental liver injury. The aim of t he study was to determine the effects of misoprostol on the course of viral hepatitis B and associated gastric mucosal injury. Methodology: Fifty two male patients with viral hepatitis B were assigned at random to receive either misoprostol (800 mu g/day), silymarin (210 mg/day) or no drug treatment at all (control group). Biochemical indices of Li ver injury were measured once a week, and HBsAg clearance was analysed 6 months later. Moreover serum levels of endogenous prostaglandins (P GE(2), PGI(2)) and stomach mucosal injury (scored endoscopically) were evaluated before and after treatment. Results: Decrease of serum conc entration of bilirubin, activities of transaminases and alkaline phosp hatase as well as hepatomegaly reduction were significantly faster in misoprostol treated patients, that resulted in significantly shorter t ime of hospitalization. The best effect of misoprostol treatment on Li ver injury was observed in patients suffering from a severe course of the disease. HBV elimination, evaluated 6 months after the disease ons et, was similar in. both groups. Misoprostol treatment had a significa nt effect on the improvement of stomach mucosal injury. Serum concentr ations of main endogenous prostaglandins produced by the liver (PGE(2) and PGI(2)), were not affected by exogenous administration of misopro stol. There were no side effects related to misoprostol or silymarin t reatment. Conclusions: Our data demonstrates the beneficial effect of misoprostol treatment in patients with viral hepatitis B. Faster conva lescence related to normalization of biochemical indices of liver inju ry and healing of associated stomach mucosal lesions was also observed .