Efficacy of systemic
enzyme therapy in the treatment of patients with chronic hepatitis
B.
Vassilenko A.M., Fessenko V.I.,
Schvets S.V. Efficacy of systemic enzyme therapy in the treatment of
patients with chronic hepatitis B. Int. J. Immunotherapy 2001, Vol.
XVII, No. 2/3/4, pp. 93-97
- ISSN 0255-9625. 218 K/375 (19-05-3).
Department of Therapy with Laboratory Diagnostics, Dnipropetrovsk
Medical Academy, Ukraine.
Summary: To study the efficacy of systemic enzyme therapy in
the treatment of patients with chronic hepatitis B virus (CHBV) in
replication phase, we treated 90 patients (mean age 34.3 ± 5.3,
disease duration 3.9 ± 2.1 years).
Twenty-eight patients
were given seven Wobenzym® tablets three times a day for 4 weeks
followed by 3-4 tablets three times a day for 20 days. Thirty-two
patients received parenteral interferon a2b (intron A) 5 million IU
per day three times a week for 24 days. Thirty patients received
Wobenzym® plus intron A simultaneously in the same dosage regimens.
The group of patients receiving Wobenzym® included mainly patients
in whom interferon therapy was contraindicated by dramatically
expressed adverse effects and patients with intraliver cholestasis.
During the 24 weeks of therapy, clinical remission and resolution of
cytolytic syndrome was achieved in 68.5% of patients administered
interferon, in 62.3% of those administered Wobenzym® and in 73.5% of
those administered combined therapy. Systemic enzyme therapy
improved immune status parameters (increase in T-lymphocytes,
normalization of T-helper/T-cytotoxic cells, decrease in the level
of circulating immune complexes and immunoglobulin G) in 89% of the
patients; this was similar to the immunomodulating action of
interferon therapy (91 %). In 97.5% of CHBV patients, systemic
enzyme therapy considerably improved the condition of the
microcirculatory channel. This effect was more highly expressed than
in patients who received interferon (46%). Systemic enzyme therapy
was especially efficient in patients with intraliver cholestasis.
Complete resolution was achieved in 63% of the patients and partial
resolution was achieved in the remainder. In patients receiving
interferon therapy, resolution of cholestasis was not observed and
urosane administration was required. HbeAg/HbeAb seroconversion was
observed with systemic enzyme therapy but in considerably fewer
patients than in those administered interferon therapy. The positive
dynamics of all the above-mentioned syndromes was expressed to a
greater degree in patients receiving combined (Wobenzym®-interferon)
therapy.
