A Randomized Controlled Study of the Effect of AT1 antagonist on Fibrosis Markers in HCV Egyptian Patients

Abstract

AIM: The aim of this study was to evaluate the effect of telmisartan and losartan on liver functions and fibrosis markers in patients with chronic hepatitis C.

METHODS: Sixty patients were randomized into 3 groups. All groups received pegylated interferon α_-2a and ribavirin. Telmisartan has been added to the first group and losartan has been added to the second group for the first 12 weeks of therapy. Blood samples have been collected before starting the treatment and after 12 weeks for counting of blood cells and measurement of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl  transferase (GGT) ,   α−₂macroglobulin, and  transforming growth factor beta (TGF-β₁) . Urinary hydroxyproline has been estimated.

RESULTS: Early virological response showed no significant difference between groups (p>0.05).  All groups had a significant decrease in serum ALT and α₂-macroglubulin compared to pretreatment values. Telmisartan group showed a significant reduction in serum AST, GGT, TGF-β, and urinary hydroxyproline compared to control. Patients treated with telmisartan and losartan suffered significantly less leucopenia and thrombocytopenia than control patients (p<0.05).

CONCLUSION: Addition of telmisartan to pegylated interferon and ribavirin may have a hepatoprotective, anti-fibrotic, and bone marrow stimulating effects in patients with chronic hepatitis C.