A lead-in with silibinin prior to triple-therapy translates into favorable treatment outcomes in difficult-to-treat HIV/Hepatitis C coinfected patients. PLoS ONE
Braun et al. investigated the efficacy and safety of a lead-in therapy with intravenous silibinin followed by triple-therapy (i.e., telaprevir in combination with peginterferon-ribavirin) in HIV/HCV-coinfected patients with advanced liver fibrosis and non-response to previous peginterferon-ribavirin. Administration of silibinin was safe, well tolerated and highly effective and resulted in a pronounced HCV RNA decline during the lead-in phase. The subsequent initiation of triple-therapy led to a sustained virologic response 12 in ten of sixteen (63%) patients, which is 3-fold higher compared with reported treatment outcomes in similar patient groups. Due to its anti-viral and anti-inflammatory properties, silibinin may serve in the future as part of the cure for hepatitis C and other viral infections and liver diseases.