COLCHICINE IN CHRONIC HEPATITIS-B - A PILOT-STUDY

Rationale: Because of its antifibrotic and anti-inflammatory effects, colchicine has been proposed as a treatment for liver disease. Early i n vitro studies have demonstrated that colchicine blocks mitosis in th e metaphase and inhibits DNA synthesis. Aim: A pilot study of hepatiti s B virus (HBV)-related/HBV-DNA+ve chronic liver disease. Patients: Ni ne biopsy-proven chronic hepatitis patients (three with cirrhosis) ent ered the study. Two of them were HBeAg+ve and seven were antiHBe(+). A ll patients were HBV-DNA+ve/antiHBc IgM+ve (index values of anti-HBc I gM ranged from 0.370 to 1.200). All of them had a major contraindicati on to interferon therapy or refused antiviral treatment. The known per sistence of positive HBsAg ranged from 2 to 21 years. Methods: After i nformed consent, the patients received 1 mg colchicine a day orally fo r 5 days-a-week over 6 months. Testing for liver enzymes and viral mar kers was performed at the baseline and after 3 and 6 months. Results: None of the patients experienced side-effects during the treatment. Th e two HBeAg+ve patients seroconverted to anti-HBe with a normalization of AST/ALT during therapy. Among the seven antiHBe+ve patients, four had a complete normalization of transaminases (one patient cleared the HBsAg with seroconversion to anti-HBs). Six of the nine patients were HBV-DNA-ve at the end of therapy and were still negative after 12 mon ths of follow-up. Conclusion: These preliminary results suggest that c olchicine might have an antiviral activity in HBV-DNA+ve chronic liver disease, and it could be regarded as an alternative therapy to interf eron.