Analytical Evaluation of the Safety and Efficacy of Herbal Hepatoprotective Products Used by Hepatitis B Patients in Plateau State

Herbal hepatoprotective products are widely used by hepatitis B patients in Nigeria, often concurrently with conventional antiviral agents, raising concerns about safety, drug-herb interactions, and interference with treatment monitoring. This study analytically evaluated the safety profile and pharmacological evidence for herbal hepatoprotective products used by chronic hepatitis B patients in Plateau State, North Central Nigeria. A cross-sectional analytical study was conducted among 140 confirmed chronic hepatitis B patients at the gastroenterology unit of a tertiary hospital in Jos. A structured interview instrument captured names and doses of all herbal products used, frequency, source of procurement, and disclosure to healthcare providers. Identified herbal products were systematically evaluated against a database of published phytochemical, toxicological, and hepatoprotective evidence. Liver function tests and hepatitis B viral load data were extracted from patient records for comparison between herbal and non-herbal users. Results showed concurrent herbal product use in 61.4 percent of patients, with only 19.8 percent disclosing use to their hepatologist. Milk thistle (Silybum marianum) preparations were most commonly used (34.3 percent), supported by limited but existing hepatoprotective evidence. Concoctions with uncharacterised ingredients were used by 41.5 percent of herbal users, for which evidence was absent. Herbal product users had significantly higher ALT levels at 12-month follow-up (p < 0.05), suggesting potential hepatotoxic contribution from some preparations. The study provides an analytical evidence synthesis relevant to clinical management and counselling of hepatitis B patients in Nigeria. Keywords: herbal medicines, hepatoprotective products, hepatitis B, Plateau State, drug-herb interactions