Vinod V. S.1 , Vijithkumar K.2 , Riyas C.3 , Malini V. S.4 , Arun S. Menon5
BACKGROUND Hepatitis A is a viral infection of children and young adults but recently being noticed among adults also especially in developed countries. Infection is transmitted through ingestion of contaminated food or water or through direct contact with an infectious person. Viral replication occurs in liver only and the usual incubation period is 15-45 days. It is usually a self-limiting illness but at times can be fatal especially in elderly and patients with underlying chronic hepatitis C infection. Many medications have been tried till date without convincing evidences. N-Acetyl Cysteine (NAC) is a thiol and a precursor of L-cysteine and glutathione (GSH.) NAC helps the body to synthesize glutathione, the body’s master antioxidant which in turn protects the liver from the damaging effect of toxins. Aim of this study was to look into the effects of NAC in acute viral hepatitis A. METHODS It was a prospective interventional study conducted in internal medicine department of a tertiary care teaching center of Palakkad district in Kerala. The study period was 5 months. All patients with symptoms suggestive of Hepatitis were considered. Those with IgM HAV positive serology were included in the study. Those with history of chronic liver disease or with positive serology for other viral liver infections were excluded from study group. They were divided into 2 groups by picking a lot and study group was given NAC. Patients in the control group were given standard symptomatic care. Paracetamol was not given to any of the patients even though many of them had already received paracetamol from elsewhere before admission. Biochemical parameters were followed up serially in both study and control groups till clinical and biochemical improvement is achieved. Data was analysed using Statistical Package for Social Sciences (SPSS) version 16. RESULTS No statistically significant association was found between the difference in total bilirubin, direct bilirubin, SGOT, SGPT and INR values on admission and discharge between the study and control groups. CONCLUSIONS Our study couldn’t demonstrate any significant role for NAC in viral hepatitis A. Further randomized studies taking into consideration a large sample size is required to prove the role of NAC in acute viral hepatitis A. however we didn’t observe any harmful effects with NAC administration to HAV patients.
