Study of Hepatoprotective Effect of Silymarin and Ursodeoxycholic Acid in Chronic Hepatitis C Patients

Hepatitis C virus is a major public health problem causing significant morbidity and mortality. Until recently, the standard treatment with peginterferon and rivabirin was far from being perfect due to its cost, poor tolerability and low SVR rates. Although, the novel direct-acting antiviral agents(DAAs) telaprevir, and boceprevir has dramatically improved SVR rates; issues such as adverse reactions, frequent dosing, and drug interactions still represent a challenge. Even overcoming these challenges with the new revolutionary development of sofosbuvir, its high cost still needs to be addressed. Therefore, the popularity of alternative medicines in CHC treatment such as silymarin and UDCA has increased. The multiple hepatoprotective effects of these drugs have made them attractive for evaluation in patients with different liver diseases. The aim of this study is to compare the hepatoprotective effect of silymarin, UDCA, and a combination therapy of both in chronic hepatitis C patients. Fourty CHC patients (16 males and 44 females) were recruited from hepatology clinic at Beni-Suef University. Patients were divided randomly into four equal groups of tens A, B, C and D, who received 420 mg/day silymarin capsules, 500 mg/day UDCA capsules, combined therapy of both, and a placebo treatment, respectively. Serum liver parameters were measured at baseline and repeated 12 weeks after therapy. A statistically significant improvement in mean serum levels of ALT, AST, and bilirubin was obtained with UDCA therapy either when administered alone or combined with silymarin. However, silymarin treatment failed to significantly affect liver function tests.