Since oxidative stress may play a pathogenetic role in chronic hepatitis C, and sustained virological response to antiviral therapy is limited in HCV1 genotype infection, a double-blind study was performed in HCV1 patients treated with pegylated interferon + ribavirin in order to assess the Evidence-Based Complementary and Alternative Medicine 7 efficacy of supplementation with the antioxidant flavonoid silymarin. In the silymarin group, a more rapid decrease in the malondialdehyde level as well as a marked decrease in superoxide dismutase and an increase in myeloperoxidase activity after twelve months of treatment were found. In particular, alanine aminotransferase normalized in 6/16 (versus control 9/16) cases and sustained virological response occurred in 3/16 (versus 7/16) patients [63] .