l-Carnitine Treatment Reduces Steatosis in Patients with Chronic Hepatitis C Treated with α-Interferon and Ribavirin

Background Hepatic steatosis is a common presentation in patients with chronic hepatitis C. Interferon α exerts both antiviral and immunomodulating actions, and influences on lipid metabolism. The aim of our study was to test whether l-carnitine reduces steatosis in patients treated with interferon and ribavirin. Patients and methods A total of 70 patients were randomly assigned to receive either leucocyte IFN alpha at a dose of 3 MIU thrice a week plus 1,000 mg ribavirin per day for 12 months (group A) or IFN alpha and ribavirin at the same dose plus 2 g carnitine per day (group B). Results Comparison of the two treatments showed significant differences between the mean values of the following parameters at the end of the treatment: ALT −68 vs −95 IU/ml (P < 0.05), total cholesterol 0.08 vs −0.91 mmol/l (P <  0.05) and triglycerides +0.25 vs −20 mmol/l (P < 0.05); and at the follow-up: AST −35 vs −65 IU/ml (P < 0.05) and ALT −55 vs −84 IU/ml (P < 0.05). All values were lower in group B (IFN + Ribavirin + Carnitine) than in group A (IFN plus Ribavirin). When comparing those patients treated with IFN + ribavirin with those treated with IFN plus ribavirin plus carnitine, the response at the end of the treatment was 48% vs 56%, and the sustained response 39% vs 46%, respectively. Conclusions Combined treatment with l-carnitine, ribavirin and IFN alpha resulted in greater antihyperlipidaemic effects and than with ribavirin and IFN alpha alone. The results of this study suggest that l-carnitine may have a role among the reduction of steatosis strategies in patients with hepatitis C treated with IFN alpha and ribavirin.