Glycyrrhizin treatment for Chronic Hepatitis C

textabstractChronic hepatitis C is a slowly progressive liver disease that may evolve into cirrhosis with its potential complications of liver failure or hepatocellular carcinoma. Current therapy with alpha-interferon is directed at viral clearance, but sustained response is only achieved in 20-40% of patients without cirrhosis, and less than 20% in patients with cirrhosis who need therapy most. Treatment for those who do not respond to antiviral therapy is highly desirable. In Japan, glycyrrhizin has been used for more than 20 years as treatment for chronic hepatitis. In randomized controlled trials, glycirrhizin induccd a significant reduction of serum uminotransferases and improvement in liver histology compared to placebo. Recently, these short-term effects have been amplified by a well-conducted retrospective study suggesting that long-term usage of glycirrhizin prevents development of hepatocellular carcinoma in chronic hepatitis C. The mechanism by which glycyrrhizin improves liver biochemistry and histology are undefined. Metabolism, phannacokilletics, side-effects, antiviral and hepatoprotective effects of glycyrrhizin are discussed