Effect of misoprostol on the course of viral hepatitis B.
BACKGROUND/AIMS: Some prostaglandins revealed hepatoprotective effects, that was confirmed mostly in experimental liver injury. The aim of the study was to determine the effects of misoprostol on the course of viral hepatitis B and associated gastric mucosal injury. METHODOLOGY: Fifty two male patients with viral hepatitis B were assigned at random to receive either misoprostol (800 micrograms/day), silymarin (210 mg/day) or no drug treatment at all (control group). Biochemical indices of liver injury were measured once a week, and HBsAg clearance was analysed 6 months later. Moreover serum levels of endogenous prostaglandins (PGE2, PGI2) and stomach mucosal injury (scored endoscopically) were evaluated before and after treatment. RESULTS: Decrease of serum concentration of bilirubin, activities of transaminases and alkaline phosphatase as well as hepatomegaly reduction were significantly faster in misoprostol treated patients, that resulted in significantly shorter time of hospitalization. The best effect of misoprostol treatment on liver injury was observed in patients suffering from a severe course of the disease. HBV elimination, evaluated 6 months after the disease onset, was similar in both groups. Misoprostol treatment had a significant effect on the improvement of stomach mucosal injury. Serum concentrations of main endogenous prostaglandins produced by the liver (PGE2 and PGI2), were not affected by exogenous administration of misoprostol. There were no side effects related to misoprostol or silymarin treatment. CONCLUSIONS: Our data demonstrates the beneficial effect of misoprostol treatment in patients with viral hepatitis B. Faster convalescence related to normalization of biochemical indices of liver injury and healing of associated stomach mucosal lesions was also observed.