Effects of carnitine on biochemical responses in patients with chronic hepatitis C treated with interferon-α

Background: Infection with hepatitis C virus (HCV) is an important healthcare problem worldwide as more than 90% of affected patients develop chronic infection. Carnitine is a fundamental substance in the production and dissemination of cellular energy and has previously been shown to improve the clinical response to interferon (IFN)-alpha treatment. We compared the effects of carnitine plus IFNalpha versus IFN alone in patients with chronic HCV-related active hepatitis C. Patients and methods: 70 patients with chronic hepatitis C diagnosed by clinical, humoral and histological findings were eligible for this randomised study. Patients were randomly assigned to one of two groups. Group A received IFNa 3 million IU three times a week for 6 months, while group B received the same dosage of IFNalpha plus carnitine 2g, orally daily. Results: After 6 months' treatment, 11 of 35 patients who received IFNalpha alone compared with 14 of 35 who received IFNa plus carnitine were considered to be complete responders. No statistically significant differences were reported between the two groups with regard to viral and histological responses. Patients who received carnitine in addition to IFNalpha tended to have more favourable changes in some biochemical parameters (including alanine aminotransferase, total cholesterol, low-density lipoprotein cholesterol and triglycerides) than patients who received IFNalpha alone, but these changes were not statistically significant. Patients treated with carnitine showed less fatigue and myalgia and better maintenance of bodyweight than those who did not receive carnitine. Conclusion: Our data showed that administering carnitine with IFNa may reduce some of the adverse effects related to the cytokine, such as myalgia and fatigue, thereby potentially improving compliance and the quality of life of treated patients. Notably, carnitine does not seem to affect the viral and histological response to IFNalpha in HCV-related chronic hepatitis.