rHB vaccination in replicative chronic asymptomatic HBsAg carriers

Viral hepatitis: clinical aspects C06/041

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TT VIRUS (TrV) PREVALENCE IN LIVER TRANSPLANTATION RECIPIENTS S. del Campo l, N. Moreno ~, J. Moreno l, M. Lumbreras2, M. Gomez2, R. Uarcena ~ ~S. de Gastroenterologia, H. U. de Getafe, Getafe, Madrid, Spain. 2S. de Digestivo, H. U. de Getafe, Getafe, Madrid, Spain. O b k t t ~ Tosmdy~ TIV ~ i n l i t = ~ ~ Palim~ m d ~ We have studied34 ~ ~ ' ~ ~ . ~ '-- ~;. •, (OLT), 28 mai~,i-cm abe 513-~.73era, ~ a ~ a s e 6:k7,s4~ohadX leest 1 ~ e ~ ~ . Tae e~_t R ~ l i ~ r ~ pmOLT ~em akxtt01ic~ h m i s in 1 9 ~

pm~yhliy~

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cintx~ I-~Ar+ in 2 Weha~e e-,~l'&e ~ d r r I V i n serumrumples~ l n e ~ , lime l~ils, laeOLT, 2 mmtl~ and 12 mmths I~t-OLT "lhe deteaim

v~sc ~ e d ~ byP(:R,,~n~.pm~ d e m ~ i~~D 1~,~27-34. P a i m were ¢Ividedi. ~ o mx~p~depmd~ m ~e pmmce (Vp; .=10) or ~ £ . m ~ (Va; n=24) ~ vkal i~ec~n by I-LW or I-~Ar p~OLT. We ha~ aim malymt and h , . ~ l ~ m m , the .,.,...~...;,9~i~ ;.-.~,,~t and

&tmVw 27/35 (7"P/o)l~6~s ~ a e TIV-DNA (-)IaeOLT, rely me case was T I V - n , W ~ (2.8*/o)in 2 - m o ~ ~ l~t..OI.,T E l ~x (17.1°/o)~

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C06/042

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rHB VACCINATION IN REPLICATIVE CHRONIC ASYMPTOMATIC HBsAg CARRIERS K. Yalgln, H. De~ertekin, S. Teke~ Hepatology Department, Dicle University Medical School, Diyarbak~r, Turkey.

In this study the effect o f rHB vaccine was investigated in.chronic HBV carriers followed six months. There were 11 patients in replicative group (RG), (5 male, 6 female). Median age was 24.6. The median level o f I-IBV D N A was 1465. There were 21 patients in non-replicative g r o u p ( N R G ) (11 male, 10 female). M e d i a n age was 25. Serological markers were screeened b y E L I S A and levels o f H B V D N A were determined by capture hybride system. H D V and H C V were negative in all patients. Liver biopsy w a s p e r f o r m e d in R G and median H A I was 1,27/18. All patients were vaccinated three times by rI-lB vaccine (20 mcg) with one m o n t h intervals. H B V D N A has b e c o m e negative in 6 o f 11 patients (60%) in R G group. H B s A g seroconversion has b e e n seen 2 o f those 6 patients. In this group 7 o f t h e m w e r e wild and 4 w e r e mutant type. H B V D N A has b e c o m e negative in all mutants and 2 o f wild types. These last 2 patients also had H B e A g seroconversion. H B s A g seroconversion has b e e n seen in one patient o f each group. There was no any other side effects. In N R G group only in one patient H B s A g has been negative

(5%). In summary the results of rHB vaccination in RG group of chronic H B V carriers s e e m to be hopeful. H B V D N A negativity was found in 60OA o f these patients and H B s A g negativity in 1/3 o f these cases. The results o f N R G group were insufficient.

C06/044

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INTERFERON/RIBAVIRIN COMBINATION THERAPY WITH AND WITHOUT DAILY DOSING IN RETREATMENT OF CHRONIC HEPATITIS C T. Bernatik ~, H. Klinker2, M. Scheurlen2, H. Meyer3, W. Norgaue#, W. Rambach 5, U. Sapper6, E.G. Hahn t, D. Schuppan 1, H.T. Schneider~ ~Department of Medicine I University Erlangen, Germany. 2Department of Medicine University W0rzburg, Wfirzburg, Germany. sSt. Klinikum Nt~rnberg, Nfirnberg, Germany. ~I'heresien-Hospital Nt~rnberg, N0rnberg, Germany. 5Heinz-Kalk-Hospital Bad Kissingen, Bad Kissingen, Germany. 6Med. Kliniken Esslingen, Esslingen, Germany. Background/Aims: To comp~rc saf~T and ~r.a~y of intm"l'¢~"ibavirm ccmbin~tinntherapywithaod withoutdailydosin8in interferoopn:tnmtedimtRz~ with chronichepatitisC. Material and MfthodJ: Since April 1998 in total 213 patients with hepatitisC not successfullytreatedby IFN-mmmtlmrapy ( n o t ~ - t ~ n=132; relapsern=Sl) wcrc im~si~tive.lymonitc,~ in a malti ~m" ~ offeringtwo dosmgregunes(seetable): ~~ Wlq~.e.Uw + Ribsvbia1000-1200m~p.o.daily S MU 11~ s.c. ~

$ MUWNs.c.~ib | +Rihavi~1000-1200m~p.o.daily I ~ MU II~s.~ ~

I

$ MU IFN s.c. tiw

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R~ults: t 58 patients were e~J'o]]ed in the STA~IDARD pt,~y.x3¢olend 55 ~

in

+Ril~vhm1000-1200m8p.o.d~ 3 MU IFN s.c. aw

17-12 [ +Ri~virial000-1200~p.~d~/

+Ril~vifin1000-1200ragp.o.dai~ I +ea~v~t~1000-1200~p.o.d~/|

thc INDUCTIONprotoooLAt ~ the results~ 6 monthsof m=tmmt arc available in 79 patients (STANDARD) and 24 lmticms (INDUCTION) r~lmtively. [n mtufmm ~ v~ogiml ~ rates of 30*/. (STANDARD) and 40°.6 (INDUCTION) werc obst=~od. In relapse patimts the virological rcspoos¢ rat~ w t ~ equaly 86% for both ~ rcgimm. "rlmm v a ~

13 break offs in the STANDARDgroup and 4 Mcak otis in the INDUCTION due to n ¢ ~ x ~ p l i m ~ . Side e f f e ~ did net diffe~signifieamtly betwem bothgroups. Condmign: An optimized~ b a v i r m combinationtherapydoe*inc~e~e the ~ rate of mmmtm~tin dmmich~mtitisC p ~ . IzdtiMd~ilydmi~$ doesnot cahanc¢thela'nmayvm~h~caln=lam~ratm after6 mont~ of Utatmam both f~ inte~eronmmrespmde~and for ~ . Whetla=initial daily dosing anla'ovessusuemdresponsehas to be shovmwithfmlm"stadyla'ogn:ss. group mi.~

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PERIHEPATIC LYMPHADENOPATHY AND THE RESPONSE TO ALPHA INTERFERON IN CHRONIC HEPATITIS C C. Fierbinteanu-Braticevici D. Andronescu Medical Clinic IV, Department of Gastroenterology, University Hospital, Bucharest, Romania. Inflammatory ~ of organs lead to h ~ (ff regional lymph

nodes. ~ ~ c

~

C the ~

l

~

(PHL)

c o n z l a ~ with the histological activity o[ the diseas~ AIM: to inv~tigntc if them is a cc~m bctwam fl~ PI~ and the lespcq~e to sl#m ~ in clmmic hep~i~ C. METHOI~: I00 paimts with live~l~sy fer beptt~s C treated with alpha ~ ~ lfigh tesdution aixk~i,ml nh~'asonogt'a#y pier and dining the course d the ram/mint. We

inve~gx~ t~ l ~

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the size and the nmnber of lymph nodea we inmxlnced a grading of P I ~ as folk)we: grade I - normal er minimal, grade l I - modetme and m,A~ Ill_ extcnsiv~ We also conclam the hepatic inflamnmery activity accert~ng to the Knoddl ~otc with PHL. Pdnmy r e ~ o n ~ to the alpha ~ was con~den~d as ncnnalisafion of ALT and neg~ive HCV- RNA witl/n 3 munths ~'thc m : m n ~ t ~ T S : According totl~ grading of PilL we found : 45 pmieam with grade L 31 lmtiems with grade II and 34 palictms

wire gradem. ]-m~ogi~ inflmmmery activitywas ~ f i ~ y in patientswith grade m comparedto the other gmd©s.The tare of p~aary respcmder was: 46% (21/45) fm grade I, 32% (10/31) for grade II and 23% (9,'34) for peaimts with grade m Dt, lng Omapy we observed an increase of PHI, in only 3 ptlimts of 40 Immary r~pond~ vmms 30 (ff 41 noare~. PHL did not change in 14 pmients and 5 pmiems had a marked decrease of PHL during therapy (4 ~ pimary responder and 1 non

resp~ade~) CONCLL~IONS : PHL mmiw~n~ by alxk~n~l ullrasonography could ~rve as an ~A-~n'onalclinical mmker in monitodng and lmXiic~g m s p o ~

to alphainterferonthen~ in chronichep,~s C.

Sa~bmF~t~ b~F.SSEXPm,m,Can.t

187