Clin Mol Hepatol.  2019 Mar;25(1):65-73. 10.3350/cmh.2018.0070.

Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection

Affiliations
  • 1Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan. moriyak@naramed-u.ac.jp
  • 2Department of Endoscopy, Nara Medical University, Nara, Japan.

Abstract

BACKGROUND/AIMS
L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease.
METHODS
A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires.
RESULTS
A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment.
CONCLUSIONS
L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.

Keyword

L-carnitine; Hemolytic anemia; Ribavirin; Chronic hepatitis C; Drug therapy

MeSH Terms

Anemia
Anemia, Hemolytic*
Carnitine*
Drug Therapy
Hepacivirus*
Hepatitis C*
Hepatitis C, Chronic
Hepatitis*
Hepatitis, Chronic
Humans
Hyperammonemia
Liver Cirrhosis
Liver Diseases
Muscle Cramp
Prospective Studies
Ribavirin
Sofosbuvir
Carnitine
Ribavirin
Sofosbuvir
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