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 hepato-cellular 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 honey-based healthy diet, regular exercise and abstinence of un-indicated 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=3.17- 16.75 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.