Oral prostaglandin (PGE(2)) therapy for chronic viral hepatitis B and C

The cytoprotective effects of prostaglandins have been utilized in the prev ention of hepatitis B virus reactivation after liver transplantation. This pilot study evaluated the effects of oral prostaglandin E-2 (PGE(2)) in chr onic viral hepatitis B and C. Twenty patients with chronic hepatitis B and 20 patients with chronic hepatitis C received 4 mg day(-1) PGE(2) for 6 mon ths, The lymphocyte antiviral enzyme 2',5'-oligoadenylate synthetase (2',5' -OAS) and peripheral blood monocyte procoagulant activity (PCA) were measur ed before, during and after the treatment, Three of 20 hepatitis B and five of 20 hepatitis C patients withdrew from the study. Eight of 17 hepatitis B patients responded: in seven of these eight patients, serum alanine amino transferase (ALT) levels normalized; loss of viral replication was sustaine d in all eight patients; and seroconversion from hepatitis B e antigen (HBe Ag) to hepatitis B e antibody (HBeAb) positivity occurred in seven patients over the 48-week: duration of this study. In 14 of the 15 hepatitis C pati ents, hepatitis C virus (HCV) RNA remained detectable and the serum ALT lev els remained elevated. 2',5'-OAS levels and PCA values did not correlate wi th other markers of response to PGE, therapy in either chronic hepatitis B or C. In summary, PGE, was associated with sustained loss of viral replicat ion in 47% of chronic hepatitis B patients; no beneficial effects were appa rent in chronic hepatitis C.