Herbs may work when drug fails against hepatitis
By Karla Gale
NEW ORLEANS (Reuters Health) - An herbal mixture that includes extracts of mistletoe and green tomato may lead to a treatment response in patients with hepatitis C infection that does not respond to interferon therapy, according to a report presented here at a large medical conference.
This concoction is not recommended as first-line treatment, however, since conventional therapy has a higher success rate with a shorter duration of treatment. The possibility also exists that mistletoe itself may be dangerous for patients with severe liver disease.
Dr. Harald Matthes and colleagues assessed the outcomes of 79 hepatitis C patients who were treated with the herbal mixture. The patients had either failed to respond to interferon therapy or had a specific reason why they couldn't receive such therapy.
After receiving the mixture for 2 years, 44 percent of patients had a complete treatment response, 28 percent had a partial response, and 28 percent had no response.
About 60 percent of patients had reactions at the injection site, but otherwise adverse events were mild and uncommon.
The researchers estimate that the cost to treat each patient who achieves a complete and sustained response is $5,600 with the herbal extracts, compared with $28,000 for interferon therapy.
In an interview with Reuters Health, Matthes, based at Charite University of Berlin, explained that the mistletoe extract activates certain immune cells that trigger an attack on the hepatitis C virus. Moreover, green tomato extract helps the liver clear infected cells, and another ingredient helps the liver to regenerate, he added.
Matthes noted that mistletoe is used in the treatment of about 60 percent of cancer patients in Germany, so its safety profile is well established. However, he would not recommend these agents as first-line treatment, since interferon is associated with a better response rate and requires only one year of treatment.
Dr. Paul Pockros, from Scripps Clinic in La Jolla, California, told Reuters Health he was concerned that herbal treatment could induce liver cell death, which could be "quite dangerous" for patients with poor liver function to begin with. He also thinks it should not be recommended until there is a better understanding of how these herbs work.
However, he agrees with Matthes that such treatment could be appropriate for patients who have no other choice of treatment for hepatitis C.
But that remains a moot point in the US, he added, because subcutaneous injections of mistletoe are considered a drug rather than a dietary substance, and have not been approved by the FDA.
The findings were presented this week at Digestive Disease Week, which is jointly sponsored by the American Association for the Study of Liver Diseases, the American Gastroenterological Association, the American Society for gastrointestinal Endoscopy, and the Society for Surgery of the Alimentary Tract.