Vitamin E (alpha-tocopherol) has been investigated as a supportive therapy in certain forms of hepatitis, particularly nonalcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease. The rationale is based on its antioxidant properties, as oxidative stress is believed to contribute to liver cell injury in hepatitis. Several randomized controlled trials, including the PIVENS trial (Sanyal et al., 2010), have shown that high-dose vitamin E (800 IU/day) can improve liver histology in non-diabetic adults with NASH, reducing inflammation and hepatic steatosis. Based on these findings, some clinical guidelines cautiously recommend vitamin E for non-diabetic patients with biopsy-proven NASH.

However, evidence for vitamin E use in other forms of hepatitis, such as viral hepatitis (hepatitis B or C), is limited and inconsistent. Most studies in viral hepatitis are small, lack rigorous design, or show minimal benefit. Furthermore, long-term safety of high-dose vitamin E supplementation is debated due to possible increased risk of all-cause mortality at very high doses.

In summary, there is moderate scientific evidence supporting vitamin E’s use in specific cases of NASH, but not for general hepatitis or viral hepatitis. Use should be carefully considered, weighing potential benefits against risks, and limited to well-defined patient groups.