The role of complementary medicine in hepatitis B

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  • Complementary medicines (CMs) are used by many patients with chronic liver disease and discussion of their use should be a part of routine clinical care.
  • Some studies have linked vitamin D status to control of hepatitis B virus (HBV) infection and markers of response including alanine aminotransferase (ALT) levels. Vitamin D supplementation should be discussed in those with documented vitamin D deficiency as supplementation may assist with the efficacy of and response to antiviral treatment.
  • In most clinical settings, apart from the specific situation of vitamin D deficiency, there are no convincing data that CMs or treatments alter the course of the illness significantly.
  • Recent studies have shown certain activities for a range of herbal products, including anti-inflammatory, antifibrotic, anti-oxidant anticancer, immunomodulatory and antiviral activities. However, more work is needed in clinical situations before the use of these individual agents can be recommended.
  • Much of the fear of toxicity relating to herbal products is based on studies that have been poorly carried out or reported. Use of the Roussel Uclaf Causality Assessment Method (RUCAM) to assess causality of drug-induced liver injury is recommended for clinicians to accurately assess hepatotoxicity.

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