Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Branched-Chain Amino Acids (BCAAs) have been studied as a supportive therapy in various liver diseases, including chronic hepatitis and cirrhosis. The scientific rationale is that in liver dysfunction, particularly advanced disease, the metabolism of amino acids is altered, leading to decreased levels of BCAAs and increased aromatic amino acids. This imbalance is linked to complications such as hepatic encephalopathy and muscle wasting (sarcopenia).

Clinical trials and observational studies have shown that BCAA supplementation may improve nutritional status and quality of life in patients with chronic liver disease. Some evidence suggests BCAAs help prevent episodes of hepatic encephalopathy and may support protein synthesis in malnourished patients. However, the majority of robust clinical trials have been conducted in cirrhotic patients or those with advanced liver failure, rather than specifically in those with hepatitis (inflammation of the liver) alone. The benefit in hepatitis without cirrhosis is less clear, and there is limited data supporting routine use solely for hepatitis.

Guidelines from hepatology societies sometimes recommend BCAAs for patients with cirrhosis who have persistent hepatic encephalopathy or protein-energy malnutrition, but not specifically for uncomplicated hepatitis. Overall, while there is a scientific basis for BCAA use in advanced liver disease, the evidence supporting their use specifically for hepatitis is limited, leading to a moderate evidence rating.

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