Use of alternative medicine in patients with chronic viral hepatitis

Abstract

Objectives: Some of the patients with chronic hepatitis use both alternative product and/or antiviral treatment. These herbal products sometimes lead to clinical deterioration. In this study we aimed to determine the purpose of alternative product utilization and rate among the chronic hepatitis B (CHB) and C (CHC) patients. Methods: This prospective cohort study included 200 consecutive adult patients with chronic hepatitis B and C at the Department of Infectious Diseases, Ondokuz Mayis University, between 1 March 2012 and 30 July 2012. At enrollment, clinical information, demographics, laboratory variables and knowledge about alternative products were recorded. Results: Of the patients 150 had CHB, 50 had CHC. 54% of patients were male. Use of alternative products was 26%. Antiviral treatment rate was 48.5% for all patients. The most used alternative products were artichoke extract and honey. 67.3% of patients were using single alternative product whereas the others were using two or more alternative products. 46.2% of patients who use alternative product provided information about the alternative product usage, but the others did not. Conclusions: Majority of patients used alternative products. More than half of these patients did not give information to their physicians about their use of alternative medicine. Use of alternative product should be asked in all patients with chronic hepatitis. Herbal product usage was detected in majority of patients and also approximately half of these patients did not give information to their doctors about taking alternative medicine. In conclusion, it is necessary to take detailed information about herbal product usage in patients with chronic hepatitis.

Keywords

• Chronic hepatitis B and C, alternative medicine

Use of alternative medicine in patients with chronic viral hepatitis

Abstract

Amaç: Kronik hepatitli hastalar antiviral ilaç tedavisiyle beraber alternatif ürünleride kullanabilirler. Alternatif ürünler bazen klinik kötüleşmeye yol açabilir. Bu çalışmada kronik hepatit B (KHB) ve kronik hepatit C (KHC)’li hastaların alternatif ürün kullanımını ve sıklıklarını belirlemeyi amaçladık. Yöntemler: Bu prospektif kohort çalışmaya Ondokuz Mayıs Üniversitesi Enfeksiyon Hastalıkları Klinik Mikrobiyoloji polikliniğinde 1 Mart-30 Temmuz 2012 tarihleri arasında kronik hepatit B ve C tanısı ile izlenen 200 yetişkin hasta dahil edildi. Hastaların klinik bilgileri, demografik, laboratuvar değerleri ve alternatif ürün kullanma bilgileri kaydedildi. Bulgular: Hastalarımızın 150’inde KHB ve 50’inde KHB infeksiyonu olup % 54’ü erkekti. Alternatif ürün kullanım oranı % 26 idi. Bütün hastalarda antiviral tedavi kullanım oranı % 48,5’idi. En sık kullanılan alternatif ürünler enginar ve baldı. Hastaların % 67,3’ü sadece bal kullanırken, diğerleri iki veya daha fazla alternatif ürün kullanıyordu. Alternatif ürün kullanan hastaların sadece % 46,2’si ilk sorgulamada ürün kullanımı hakkında bilgiyi verirken diğerleri vermedi.Sonuç: Çalışmaya alınan hastaların çoğunluğunda alternatif ürün kullanımı belirlenirken hastaların yarısı alternatif ürün kullandıkları hakkında doktoruna bilgi vermedi. Sonuç olarak kronik hepatitli her hastada alternatif ürün kullanımı detaylı şekilde sorgulanmalıdır

Keywords

• Kronik hepatit B ve C, alternatif ürün

References

1. Traditional Medicine. http://www.who.int/mediacentre/fact- sheets/fs134/en/ Accessed October 1,2012.
2. Sarısen O, Caliskan D. Fitoterapi: Bitkilerle tedaviye dikkat. Sted 2005; 14:182-187.
3. Gürün MS. Bitkisel tıp. ANKEM Derg 2004; 18:133-136.
4. Dienstang JL, Isselbacher KJ. Toxic and Drug-induced Hepa- titis. Principles of Internal Medicine, 16th edn. McGraw-Hill: Kasper DL, 2005;1843-1844.
5. White CP, Hirsch G, Patel S, et al. Complementary and al- ternative medicine use by patients chronically infected with hepatitis C virus. Can J Gastroenterol 2007;21:589-595.
6. Ferrucci LM, Bell BP, Dhotre KB, et al. Complementary and alternative medicine use in Chronic Liver Disease Patients. J Clin Gasroenterol 2010;44:40-45.
7. Seeff LB, Curto TM, Szabo G, et al. Herbal product use by per- sons enrolled in the hepatitis C antiviral long-term treatment against cirrhosis trial. Hepatology 2008;47:605-612.
8. Zhang L, Wang G, Hou W, et al. Contemporary clinical re- search of traditional Chinese medicines for chronic hepatitis B in China: an analytical review. Hepatology 2010;51:690- 698.

9. Gamsizkan Z, Yücel A, Kartal M. Using of herbal product. Jour- nal of Clinical and Analytical Medicine 2012;3:300-302.
10. Schaefer M, Capuron L, Friebe A, et al. Hepatitis C infection, antiviral treatment and mental health: a European expert consensus statement. J Hepatol 2012;57:1379-1390.
11. Bardia A, Nisly NL, Zimmerman MB, et al. Use of herbs among adults based on evidence-based indications: findings from the National Health Interview Survey. Mayo Clin Proc 2007;82:561-566.
12. Kennedy J. Herb and supplement use in the US Population. Clin Therap 2005;27:1847-1858.
13. Meisel C, Johne A, Roots I. Fatal intracerebral mass bleed- ing associated with G. biloba and ibuprofen. Atherosclerosis 2003;167:367.