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Effect of Combination of Some Natural Products and Chloroquine on HCV Infection in Egyptian Patients: Pilot Study

Zaki Sheir, Gamal Badra, Ossama Salama, Asmaa I Gomaa and Wesam Saber

Background: Studies using safe natural products {Blue green® tablet (Rhodiola rosea L. root dry extract; Eleutherococcus senticosus Maxim. root dry extract; Ginkgo biloba L. leaf dry extract; Klamath microalgae Aphanizomenon flos aquae (AFA) 50 mg)} showed its antiviral effect. As well as vitamin D3, linolenic acid, black seeds and honey. The aim of the study was to determine the efficacy of combination of these natural products and chloroquine in treatment of HCV patients refusing or unfit for combined Interferon and Ribavirin (INF/RBV) therapy or HCV patients who failed to achieve sustained virological response to INF/RBV.

Methods: Patients with detectable HCV RNA with different stages of fibrosis and cirrhosis refusing or unfit for combined Interferon Ribavirin (INF/RBV) therapy or patients who failed to achieve sustained virological response to INF/RBV from April 2009 to March 2012 were included in this study. All the patients were treated first from coinfection as schistosomiasis and helicobacter pylori if present then received combination Blue green® tablet-original natural company, Italy; 2 tablet/30 kg once daily; Vitamin D: 1000 IU/day; tablespoon filled with paste made of linolenic acid, black seeds powder and honey; and 250 mg chloroquine once daily for 10 days and then every 3 days through the duration of therapy.

Results: 195 patients with chronic HCV were included; mean age 47.8 ± 9.03 years, 67.7% males. All patients have chronic hepatitis. 24 patients had cirrhosis. 82 (42.1%) achieved negative HCV RNA after 6 months of treatment. After 12 months of treatment, 107 (54.9%) patients had negative HCV RNA. 125 (64.3%) patients achieved ETR after 18 months of treatment. Moreover, 4/6 (66.6%) patients with combined HCV and HBV showed undetectable HBV after 3 months. Two out of 8 (25%) patients who failed to achieve SVR with previous (INF/RBV) have ETR.

Conclusion: Combination of safe natural products (Blue green® tablet, vitamin D3, linolenic acid, black seeds and honey) and chloroquine may have a role to achieve SVR in combination with recent direct acting antiviral drugs for HCV infection.