Sustained Hepatitis C Virus Clearance was Achieved by Honey Based Conservative Management in 35% of Chronic Hepatitis C Virus Patients: A Prospective Cohort Study

Background: Hepatitis RNA viruses include A, B, C and D. They are typically self-limiting by conservative measures, except hepatitis C virus (HCV) that is self-limiting in only 2-5%. HCV causes chronic infection affecting 170 million people worldwide, its prevalence peak in Egypt is 12.1%. About 5%-7% of patients may ultimately die of consequences of HCV infection, e.g. cirrhosis, and hepatocellular carcinoma. Objective: To assess effectiveness of conservative management in chronic HCV patients. Methods: In a prospective cohort trial 82 patients with chronic HCV (49 children and 33 adults) were advised honeybased healthy diet, regular exercise and abstinence of unindicated medications. None received concomitant antiviral or interferon therapy. HCV infection diagnosis relies on qualitative HCV RNA diagnosis by nested RT-PCR. Work was conducted in Hepatology Clinic, New Children Hospital, Cairo University, National Egyptian Center for Clinical and Environmental Toxicologic Research, Cairo University & National Cancer Institute, Cairo University during 2008 – 2011. Results: At enrollment mean age ±standard deviation (±SD) of children was 9.08 years ±3.5 years (range=3.1716.75 years, median=9.83 years) and 43 year ± 11.25 years (range=18.5-61 years, median=46 years) for adults. Conservative management was effective in sustaining HCV clearance in 29 (35%). None suffered progression of liver condition. Breakthrough viremia was observed in 8 (9.8%). For those with final lack of virus clearance, HCV load dropped significantly (p=0.007). Sustained HCV clearance correlated positively with younger age (p=0.024), female sex (p=0.037), height attainment in children who were shorter for age at initiation of trial (p=0.002), and negatively with history of anesthesia (p=0.004), previous operative intervention (p=0.000), and did not correlate with initial HCV load (p=0.468). Predictors of response to conservative management await exploration. The HCV sustained clearance was irrespective of initial HCV load. Correspondence to: Dr. Magd A. Kotb, The Department of Pediatrics, Faculty of Medicine, Cairo University Conclusion: Conservative management achieved 35% cure of HCV in our studied cohort. It is safe and cost effective. Conservative management in HCV, warrants its trial as a first line of management in chronic HCV patients.