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Bile acids for viral hepatitis.

W Chen¹, J Liu, C Gluud

¹Toronto Western Hospital, University Health Network, University of Toronto, Liver Clinic, Room 181, 6B Fell Pav, 399 Bathurst St, Toronto, Ontario, Canada, M5T 2S8. wdchen@uhnres.utoronto.ca

The Cochrane Database of Systematic Reviews

|October 19, 2007

Summary

Bile acids improve liver enzymes in viral hepatitis B and C but do not clear the virus. More high-quality trials are needed to confirm benefits for long-term outcomes.

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Lipid Droplet Isolation for Quantitative Mass Spectrometry Analysis

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Published on: April 17, 2017

Area of Science:

Hepatology
Gastroenterology
Pharmacology

Background:

Bile acids are being investigated for viral hepatitis treatment.
Current evidence on their efficacy is inconclusive.

Purpose of the Study:

To evaluate the beneficial and harmful effects of bile acids in patients with viral hepatitis.
To synthesize findings from randomized clinical trials on bile acid therapy.

Main Methods:

Comprehensive literature search across multiple databases (Cochrane Hepato-Biliary Group, Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, Chinese Biomedical Database) up to July 2007.
Inclusion of randomized clinical trials comparing bile acids with placebo or no intervention for viral hepatitis, regardless of publication status or language.
Data extraction and methodological quality assessment focusing on sequence generation, allocation concealment, blinding, and follow-up; outcomes reported as relative risks (RR) or weighted mean differences (WMD) with 95% confidence intervals (CI).

Main Results:

Twenty-nine trials for hepatitis B or C were identified; none were of high methodological quality.
Ursodeoxycholic acid (UDCA) showed some benefit in acute and chronic hepatitis B, reducing antigen positivity and abnormal transaminases.
For chronic hepatitis C, bile acids significantly decreased abnormal alanine aminotransferase levels but did not affect HCV RNA clearance or cirrhosis; they increased the Knodell score.

Conclusions:

Bile acids improve serum transaminase levels in hepatitis B and C but do not aid viral clearance.
Insufficient evidence exists regarding the impact of bile acids on long-term outcomes like liver cancer or mortality.
High-quality randomized trials are essential to determine the clinical utility of bile acids for viral hepatitis.