Effect of ursodeoxycholic acid administration in patients with acute viralhepatitis: a pilot study

Background: Ursodeoxycholic acid (UDCA) is able to improve biochemical mark ers of cholestasis, with a parallel decrease in transaminases, in various c holestatic liver diseases. Aim: To evaluate the effects of UDCA administration on acute viral hepatiti s-related cholestasis and the course of acute viral hepatitis. Methods: Seventy-nine consecutive patients with acute viral hepatitis (HBV: 43. HCV: 11, HAV: 15, HEV: 3, Non A-E: 7) were randomized to receive eithe r UDCA for 3 weeks or no treatment, Liver biochemistry and serum bile acid determinations were run at weekly intervals, Results: No significant differences were observed in mean percentage decrea ses in transaminases between treated and untreated patients. By contrast, c holestatic indexes decreased significantly more quickly in patients treated with UDCA than in controls, and this effect was more evident in patients w ith increasing alanine transaminase levels at admission. After a peak at th e end of the first week of therapy, serum levels of conjugated ursodeoxycho lic acid (CUDCA) showed a gradual decrease. Conjugated cholic acid (CCA) an d chenodeoxycholic acid (CCDCA) showed a progressive decrease with the reso lution of viral hepatitis, but no influence of UDCA administration was obse rved. Conclusions: Our study demonstrates that UDCA significantly improves choles tatic indices in patients with acute viral hepatitis, but this effect does not seem to affect the course of the illness.