Oral silymarin for chronic hepatitis C - a retrospective analysis comparing three dose regimens

To investigate the effects of silymarin on aminotransferase levels in patients with chronic hepatitis C, a standardized treatment with 420mg, 840mg or 1260mg per day was performed in patients of our clinic, who were not eligible for treatment with pegylated interferon and ribavirin. Aminotransferase levels were determined before, at 3-6 week intervals during and at the end of treatment. Predefined inclusion criteria for the retrospective analysis were persistently elevated alanine aminotransferase (ALT) levels (at least 6 months prior to and at beginning of the treatment) and treatment duration of at least three weeks. Liver cirrhosis CHILD B or C, interferon therapy within the last three months before treatment with silymarin, alcohol use >30 g/d, coinfection with hepatitis B virus or other severe diseases were exclusion criteria. According to these criteria 40 patients (13 with 420mg, 20 with 840mg and 7 with 1260mg silymarin per day) were eligible for the analysis. The mean treatment period was 125 +/- 78 days. ALT, aspartate aminotransferase and gamma glutamyltransferase levels did not change significantly from baseline in any group and there were no differences between the treatment groups. Bilirubin and prothrombine time were normal in all but one patient and remained unchanged. Silymarin therapy had no side effects. Silymarin at the doses used, does not improve elevated aminotransferases in patients with chronic hepatitis C.