Thiamine treatment of chronic hepatitis B infection

OBJECTIVE: Chronic hepatitis B is an international health concern that caus es cirrhosis, hepatocellular carcinoma, liver failure, and death. Current t reatment options are expensive and associated with side effects; however, i ndirect evidence suggests a relationship between relative thiamine deficien cy and chronic hepatitis B infection. METHODS: The authors present three case studies wherein multiple crossovers of daily thiamine administration were used to evaluate a hypothesized asso ciation between thiamine treatment and aminotransferase levels. RESULTS: In each case study, thiamine administration was associated with re duction in aminotransferase levels and the fall of HBV DNA to undetectable levels. Analyses by t test demonstrated a statistically significant reducti on in aminotransferase levels in all three cases. CONCLUSIONS: The relationship between thiamine administration and chronic h epatitis B infection warrants further study. If proven effective in reducin g liver damage or inducing remission of the hepatitis B virus in larger tri als, thiamine will offer obvious advantages over the current treatments for chronic viral hepatitis B infection. (C) 2001 by Am. Cell. of Gastroentero logy.