Scandinavian Journal of Infectious Diseases
ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19
Coenzyme-B12 Therapy in Acute Viral Hepatitis Sten Iwarson & Johan Lindberg To cite this article: Sten Iwarson & Johan Lindberg (1977) Coenzyme-B12 Therapy in Acute Viral Hepatitis, Scandinavian Journal of Infectious Diseases, 9:2, 157-158, DOI: 10.3109/ inf.1977.9.issue-2.22 To link to this article: http://dx.doi.org/10.3109/inf.1977.9.issue-2.22
Published online: 02 Jan 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=infd19 Download by: [RMIT University Library]
Date: 01 April 2016, At: 04:22
Scand J Infect Dis 9: 157-158, 1977
Short Communication
Coenzyme-B,, Therapy in Acute Viral Hepatitis STEN IWARSON and JOHAN LINDBERG
Downloaded by [RMIT University Library] at 04:22 01 April 2016
From the Department of Infectious Diseases, East Hospital, University of Goteborg, Goteborg, Sweden
ABSTRACT. Extra vitamins are needed to repair tissue damage and compensate for diminished hepatic storage during viral hepatitis. Coenzyme-B,, has recently been synthesized and ought to have a favourable effect on the damaged liver cell as has previously been reported for cyanocobalamin, since it is better absorbed by oral administration and to a greater extent accumulated in the liver. Two groups of patients from the same hepatitis A epidemic were treated with either coenzyme-B,, or cyanocobalamin. A more rapid return of serum amhotransferase (S-ALAT) levels to normal was observed in the group treated with coenzymel,,.
INTRODUCTION Vitamin B depletion is common in hepatocellular liver disease attributable to release from necrotic cells and to an increased need for nucleic acid synthesis and liver cell regeneration (1, 6). Extra vitamins are needed to repair tissue damage and compensate for diminished hepatic storage capacity (7). In 1952, Pruit and Campbell (10) reported a favourable effect of cyanocobalamin in treatment of viral hepatitis. Coenzyme-B, (which has recently been synthesized) is more readily absorbed by oral administration than cyanocobalamin and also to a greater extent accumulated in the human liver (3). In the present study the therapeutic effect of coenzyme-BI2 in hepatitis A has been compared to that of hydroxycobalamin. PATIENTS AND METHODS Two groups of patients from the same epidemic of short incubation hepatitis A were studied. The epidemic occurred in October 1972 among workers at a large car factory. Admitted patients who were born on even years received hydroxycobalamin (Hepagon Novum, Astra, Sweden) in a dosage of 1 mg per day intramuscularly for 12 days, followed by 1 mg daily by mouth until a total period of 35 days. Patients born on uneven years were treated with coenzymeB,, (Cobamamide, Astra) in a dosage of 1 mg daily intramuscularly for 12 days, also followed by 1 mg orally per day until 35 days were reached. Only patients of 15-45 years admitted to the clinic within 5 days after onset of jaundice and who had a
minimum level of total serum bilirubin of 3.0 mg/lOO ml (upper nonnal limit 1.0 mg/lOO ml) were included. The two groups counted 20 patients each. The mean age of the Cobamamide-treated group was 26.9 years, and of the Hepagon Novum-treated group 30.8 years. The delay from onset of jaundice until the treatment with vitamin B,, or coenzyme-B,, started, was similar in the two groups (4-7 days). All patients had to rest in bed in the hospital during the period of abnormal serum bilirubin levels (at least 12 days). After that the patients were followed up with liver function tests once a week as outpatients. The treatment also included an oral multivitamin preparation not containing vitamin B12 (Akvavimin, Astra) which was given 3 times daily for at least 35 days. No other drugs were given. The clinical diagnosis of viral hepatitis was confinned by liver biopsy and histopathological studies in 68 %. No patient had demonstrable hepatitis B surface antigen in serum as measured by counterelectrophoresis and radioimmunoassay (Ausria 11). Methods of the biochemical liver function tests used and normal levels have been published previously (4). The statistical analyses of differences between the groups were made by the Xz-test.
RESULTS AND CONCLUSION The number of patients still having abnormal levels (>25 IU) of aminotransferases (S-GOTWASAT and S-GPT/S-ALAT) at different occasions after onset of jaundice is shown in Table I. The group treated with coenzyme-B, showed a tendency to a more rapid normalization of S-ASAT and S-ALAT as compared with the hydroxyScand J Infect Dis 9
158
S . Zwarson and J . Lindberg
Table I . Number (and per cent) of hepatitis patients still having abnormal levels of aminotransferases during the week indicated Week after onset of jaundice Treatment groups
2nd
3rd
4th
a favourable therapeutic effect of this coenzyme on the damaged liver cell. Further clinical trials will reveal whether it has a place in the routine treatment of viral hepatitis.
5th
REFERENCES
Downloaded by [RMIT University Library] at 04:22 01 April 2016
Coenzyme-B,, (N=20) S-ALAT 18 (90%) 14 (70%) 6 (30%) S-ASAT 16 (80%) 6(30%) 4(20%) Cyanocobalamin (N=20) S-ALAT 20 (100%) 16 (80%) 12 (60%) S-ASAT 17 (85%) lO(50%) 8(40%)
3 (15%) 2(10%) 7(35%) 6(30%)
cobalamin treated patients. A statistically significant difference appeared in the 4th week after onset of jaundice, although only for S-ASAT (P
ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19
Coenzyme-B12 Therapy in Acute Viral Hepatitis Sten Iwarson & Johan Lindberg To cite this article: Sten Iwarson & Johan Lindberg (1977) Coenzyme-B12 Therapy in Acute Viral Hepatitis, Scandinavian Journal of Infectious Diseases, 9:2, 157-158, DOI: 10.3109/ inf.1977.9.issue-2.22 To link to this article: http://dx.doi.org/10.3109/inf.1977.9.issue-2.22
Published online: 02 Jan 2015.
Submit your article to this journal
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=infd19 Download by: [RMIT University Library]
Date: 01 April 2016, At: 04:22
Scand J Infect Dis 9: 157-158, 1977
Short Communication
Coenzyme-B,, Therapy in Acute Viral Hepatitis STEN IWARSON and JOHAN LINDBERG
Downloaded by [RMIT University Library] at 04:22 01 April 2016
From the Department of Infectious Diseases, East Hospital, University of Goteborg, Goteborg, Sweden
ABSTRACT. Extra vitamins are needed to repair tissue damage and compensate for diminished hepatic storage during viral hepatitis. Coenzyme-B,, has recently been synthesized and ought to have a favourable effect on the damaged liver cell as has previously been reported for cyanocobalamin, since it is better absorbed by oral administration and to a greater extent accumulated in the liver. Two groups of patients from the same hepatitis A epidemic were treated with either coenzyme-B,, or cyanocobalamin. A more rapid return of serum amhotransferase (S-ALAT) levels to normal was observed in the group treated with coenzymel,,.
INTRODUCTION Vitamin B depletion is common in hepatocellular liver disease attributable to release from necrotic cells and to an increased need for nucleic acid synthesis and liver cell regeneration (1, 6). Extra vitamins are needed to repair tissue damage and compensate for diminished hepatic storage capacity (7). In 1952, Pruit and Campbell (10) reported a favourable effect of cyanocobalamin in treatment of viral hepatitis. Coenzyme-B, (which has recently been synthesized) is more readily absorbed by oral administration than cyanocobalamin and also to a greater extent accumulated in the human liver (3). In the present study the therapeutic effect of coenzyme-BI2 in hepatitis A has been compared to that of hydroxycobalamin. PATIENTS AND METHODS Two groups of patients from the same epidemic of short incubation hepatitis A were studied. The epidemic occurred in October 1972 among workers at a large car factory. Admitted patients who were born on even years received hydroxycobalamin (Hepagon Novum, Astra, Sweden) in a dosage of 1 mg per day intramuscularly for 12 days, followed by 1 mg daily by mouth until a total period of 35 days. Patients born on uneven years were treated with coenzymeB,, (Cobamamide, Astra) in a dosage of 1 mg daily intramuscularly for 12 days, also followed by 1 mg orally per day until 35 days were reached. Only patients of 15-45 years admitted to the clinic within 5 days after onset of jaundice and who had a
minimum level of total serum bilirubin of 3.0 mg/lOO ml (upper nonnal limit 1.0 mg/lOO ml) were included. The two groups counted 20 patients each. The mean age of the Cobamamide-treated group was 26.9 years, and of the Hepagon Novum-treated group 30.8 years. The delay from onset of jaundice until the treatment with vitamin B,, or coenzyme-B,, started, was similar in the two groups (4-7 days). All patients had to rest in bed in the hospital during the period of abnormal serum bilirubin levels (at least 12 days). After that the patients were followed up with liver function tests once a week as outpatients. The treatment also included an oral multivitamin preparation not containing vitamin B12 (Akvavimin, Astra) which was given 3 times daily for at least 35 days. No other drugs were given. The clinical diagnosis of viral hepatitis was confinned by liver biopsy and histopathological studies in 68 %. No patient had demonstrable hepatitis B surface antigen in serum as measured by counterelectrophoresis and radioimmunoassay (Ausria 11). Methods of the biochemical liver function tests used and normal levels have been published previously (4). The statistical analyses of differences between the groups were made by the Xz-test.
RESULTS AND CONCLUSION The number of patients still having abnormal levels (>25 IU) of aminotransferases (S-GOTWASAT and S-GPT/S-ALAT) at different occasions after onset of jaundice is shown in Table I. The group treated with coenzyme-B, showed a tendency to a more rapid normalization of S-ASAT and S-ALAT as compared with the hydroxyScand J Infect Dis 9
158
S . Zwarson and J . Lindberg
Table I . Number (and per cent) of hepatitis patients still having abnormal levels of aminotransferases during the week indicated Week after onset of jaundice Treatment groups
2nd
3rd
4th
a favourable therapeutic effect of this coenzyme on the damaged liver cell. Further clinical trials will reveal whether it has a place in the routine treatment of viral hepatitis.
5th
REFERENCES
Downloaded by [RMIT University Library] at 04:22 01 April 2016
Coenzyme-B,, (N=20) S-ALAT 18 (90%) 14 (70%) 6 (30%) S-ASAT 16 (80%) 6(30%) 4(20%) Cyanocobalamin (N=20) S-ALAT 20 (100%) 16 (80%) 12 (60%) S-ASAT 17 (85%) lO(50%) 8(40%)
3 (15%) 2(10%) 7(35%) 6(30%)
cobalamin treated patients. A statistically significant difference appeared in the 4th week after onset of jaundice, although only for S-ASAT (P
