Complementary Therapies in Chronic HCV: Exploitation or Something to Offer?

Hepatitis C is a major cause of mortality and morbidity worldwide. Approved treatments for hepatitis C include standard interferon or pegylated interferon plus ribavirin therapy, which are costly, limited in their efficacy and carry the risk of adverse events. Patients with hepatitis C often seek alternative treatments to either complement or replace standard therapies; these include antioxidants, silymarin (milk thistle), glycyrrhizin (liquorice root), Chinese traditional medicine, Japanese Kampo medicine and thymic extracts. Many of these compounds have been shown to protect against experimental liver disease in vitro or in animal models via their potential antioxidant, antifibrotic or immunomodulatory activities. None, however, have been shown to be consistently effective in ameliorating the course of hepatitis C in properly conducted randomized controlled trials. Moreover, the production of herbal products is not regulated in the same manner as pharmaceuticals. As these products continue to become more mainstream, appropriately designed and conducted randomized controlled trials must be performed in order to better assess the safety and efficacy of these preparations prior to their integration into the common practice of Western medicine for the treatment of hepatitis C.