Use of Mucomyst (NAC) to Ameliorate Oxidant Stress as Measured by Surrogate Serum in Patients With Hepatitis C

The Effects of N-Acetylcysteine on Oxidative Stress in Chronic Hepatitis C

Objective:

There is evidence that suggests oxidative stress plays a role in the pathologic mechanism of disease progression in chronic hepatitis C virus infection (HCV). This study will test the hypothesis that N-acetylcysteine given over one month will decrease oxidative stress and thus slow disease progression.

Background:

Chronic hepatitis C is the most common blood borne infection in the United States. An average of 230,000 new infections occurred each year during the 1980s, although since 1989 the annual number of new infections has declined by greater than 80% to 36,000 by 1996.1,2,3 A CDC survey in 2003 showed that annual new cases had declined to 30,000.4 The Third National Health and Nutrition Examination Survey (NHANES III), conducted during 1988-1994, indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV. In the general population, the highest prevalence rates of HCV infection are found among persons aged 30-49 years and among males. Unlike the racial/ethnic pattern of acute disease, African Americans have a substantially higher prevalence of HCV infection than do whites.5 Population-based studies indicate that 40% of chronic liver disease is HCV-related, resulting in estimated deaths of 8,000-10,000 each year. According to the CDC, estimated medical and work-loss costs of HCV-related acute and chronic liver disease are greater than $600 million annually, and HCV-associated end-stage liver disease is the most frequent indication for liver transplantation among adults.1