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The effect of alpha - 2b - interferon on lipid profile of patients with chronic hepatitis
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A COMPARISON OF HISTOLOGICAL,BIOCHEMICAL AND SEROLOGICAL PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS B TREATED WITH INTERFERON- ALFA.
UDCA. ALTERNATIVE TREATMENT IN DISTINCT CATEGORIES OF PATIENTS WITH CHRONIC HEPATITIS C. S. Kanatakis’. D. Koutsis. A. Aaaelou. A. Moussionis. S. Dritsas 3ti Medical Department, Hellenic Red Cross Hospital, Athens.
U.Janas-Skulina”). J.Caban”‘. D.Sk~lina’~).W.Szcze~a&i(~), (1) M.Zeic-Baisamwi&_W_Wamn&?~ ‘I’D artments of Infectious Diseases ‘2’Gastroentrology, “‘Pa~omorphology, Jagiellonian U&ersity, Cracow, Poland, Aim: TO assess tbe relationship between histological, bio&emi& and SerOlOgiCalchanges in patients with CH-B, I-IBeAg positive undergoing 1FN-a treatment. Patients and methods: 55 patients (20 females and 35 males) aged 16-69 years were studied. All were treated with interferon a-n1 (Wellferon) 3 MU i.m. ewry second day for 6 to 12 months. Biochemical. serological and biopsy samples were tested prior to treatment and 20 months after IFN-therapy. A =miquantitivazcorintrscoringsystem was used to assess the grade of hflamatory activity and stage of fibrosis (Am. J. Surg. Pathol; 1995;
19 (12): 140911417). The efficacy oftreatment was assess by HBeAg clerance, anti-HBe seroconversion, histologic improvement and normal ALT levels. Results: The global response to 1FN-a therapy was about 58% (32/55). A serological and biochemical response was observed in patientswith a higher mdingscore (35.5% vs 11.5%) and staging (40.0% vs 17.5%) in the first liver biqxy. Patients witb high initial biochemical parameters (ALT, MT, QG) mm m ehib&d histological improvement. Females more So than males shod ~pro~m~t in grade(85.0% vs 54.3%) 20%). Conclusions: We formdthat Pdm w@h
CO6/091
1
UDCA has been used recently in some studies either as adjuvant therapy with IFN or as mono-therapy, in chronic hepatitis C. Puroose of the study : Was to investigate the influence of UDCA in distinct cateaories of oatients with chronic heoatitis C. Material and Mkthods : ‘Forty two patients (m.age 81 years), 14 M and 28 W with chronic heoatitis C were treated with UDCA bOOmg/day for one year. Ten’ patients (group I) had been treated with IFN unsuccessfully in the past while 10 of age > 70 years (group II) and 22 (group Ill) with coexistent diseases (diabetes melitus. cardiopathy, psychiatric diseases) had never been treated. All patients were examined for ALT yGT, ALP, PT every month and for IgG levels and protein electrophoresis evety 3 months. Results : Three out of ten patients of group I (30%), 8 out of 10 of group II (80%) and 15 out of 22 of group Ill (68%) showed normal levels of ALT I-3mo afler the treatment was started and continued to be normal during the whole period of treatment. Among these 26 patients 20 (76%) showed also normal levels of yGT. Prothrombin time, g-globulins and IgG immunoglubulin levels showed a definite improvement but they did not attain in normal levels. ALP levels were found slightly increased before treatment but returned to normal levels soon after. Conclusions : As UDCA was well tolerated could be used as alternative treatment in patients with chronic hepatitis C and age > 70 years as well as in those who cannot be treated with IFN.
Staging scores in the first biopsd showed a more to IFNU
treatment.
THE EFFECT OF ALPHA - 2b - INTERFERON ON PROFILE OF PATIENTS WITH CHRONIC HEPATITIS S. Kanatakis. C. Petroaiannoooulos.’ D. Koutsis. A. Aoelou, A. Zaharof. and A. Moussioni& 3’ and 2”4 Department
of Medicine,
Hellenic
LIPID
Red Cross Hospital.
still remains the main agent for the Alpha - 2b - Interferon treatment of chronic hepatitis B and C having some side effects from many systems. Puroose of the study : Was to investigate if interferon influences the lipides and lipoproteins of patients with chronic hepatitis during one year therapy. Material and methods : We studied 32 patients (m. age 40.7 years), 24 men and 8 women with chronic heyatifis B (8 patients) and C (24 patients) starting therapy with 6.10 Units every second day for hepatitis C and 5.103 Units every second day for hepatitis B. Liver functions tests, HbeAg. HBV-DNA, anti-HCV and lipid profile of all the patients were measured before, during and at the end of one year therapy. Results : From the twenty four patients with hepatitis C eleven (46%) of them had full response while four patients (50%) with hepatitis B did not. As concern as the lipid profile of all the patients total cholesterol (TC) was 204.2 mg% before therapy to 178.8 mg% at the end of therapy, LDL-cholesterol from 139.3 mg% to 125.1 mg%, HDL-cholesterol from 47 mg% to 53.2 mg%, triglycerides from 158.2 mg% to 128,5 mg%, Apoprotein-A from 150.7 mg% to 148.7 mg%, Apoprotein-B from Ill .3 mg% to 98.7 mg% and Lipoprotein-a from 13.6 mg% to 13.4 mg% after one year therapy. Conclusions : Apart the beneficial effects on the liver function tests Alpha - 2b - interferon seems to have a slight beneficial effect on the lipid profile improving all the lipids and lipoproteins parameters.
,VIRAL FACTORS PREDICTING RESPONSE TO INTERFERON ALFA THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C - FOLLOW-UP OF 87 CASES J.J. Staticzak1x2, J. Opoka-Kegler’, J. Baran3, E. Tobolewska’, A. Horbanls3. ‘Hospital for Infectious Diseases, *CD&T AIDS, 31BB PAS, Warsaw, Poland The relation between viral factors (genotype and viral load) and response to Interferon therapy of patients with chronic hepatitis C was estimated. The results of follow-up of 87 patients treated with 3 MU of IFN-alfa trite weekly for 6 months are presented. Methods: HCV genotypes were recognized with INNOLiPA HCV II test (Innogenetic). Serum HCV RNA level was measured by HCV Monitor test (Roche). Results: out of 87 patients in 11 cases la, in 67-lb, , in S-3a and in 4 cases 4c4d genotypes were identified. Baseline serum HCV RNA level varied from 1.2x105 copies/ml (three cases) to 1.8x lo6 (two cases). In 79 cases viral load was in 3.5x105-7.5~10~ range. All patients were followed for 6-24 months (median 14) from the end of treatment. We found 14 cases of sustained response normal ALT level. and undetectable HCV RNA at least 6 months after ending IFN treatment. In this group were 2 patients with la, 7 -lb, 3 -3a and 2 -4c4d genotype. Sustained responders were in group of viral load ranging from 1.2~10~ to 4,6x10’. Conclusion: very high prevalence of HCV genotype 1 in Poland makes viral load more useful viral factor predicting response to IFN therapy comparing to HCV genotype.
[
1
A COMPARISON OF HISTOLOGICAL,BIOCHEMICAL AND SEROLOGICAL PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS B TREATED WITH INTERFERON- ALFA.
UDCA. ALTERNATIVE TREATMENT IN DISTINCT CATEGORIES OF PATIENTS WITH CHRONIC HEPATITIS C. S. Kanatakis’. D. Koutsis. A. Aaaelou. A. Moussionis. S. Dritsas 3ti Medical Department, Hellenic Red Cross Hospital, Athens.
U.Janas-Skulina”). J.Caban”‘. D.Sk~lina’~).W.Szcze~a&i(~), (1) M.Zeic-Baisamwi&_W_Wamn&?~ ‘I’D artments of Infectious Diseases ‘2’Gastroentrology, “‘Pa~omorphology, Jagiellonian U&ersity, Cracow, Poland, Aim: TO assess tbe relationship between histological, bio&emi& and SerOlOgiCalchanges in patients with CH-B, I-IBeAg positive undergoing 1FN-a treatment. Patients and methods: 55 patients (20 females and 35 males) aged 16-69 years were studied. All were treated with interferon a-n1 (Wellferon) 3 MU i.m. ewry second day for 6 to 12 months. Biochemical. serological and biopsy samples were tested prior to treatment and 20 months after IFN-therapy. A =miquantitivazcorintrscoringsystem was used to assess the grade of hflamatory activity and stage of fibrosis (Am. J. Surg. Pathol; 1995;
19 (12): 140911417). The efficacy oftreatment was assess by HBeAg clerance, anti-HBe seroconversion, histologic improvement and normal ALT levels. Results: The global response to 1FN-a therapy was about 58% (32/55). A serological and biochemical response was observed in patientswith a higher mdingscore (35.5% vs 11.5%) and staging (40.0% vs 17.5%) in the first liver biqxy. Patients witb high initial biochemical parameters (ALT, MT, QG) mm m ehib&d histological improvement. Females more So than males shod ~pro~m~t in grade(85.0% vs 54.3%) 20%). Conclusions: We formdthat Pdm w@h
CO6/091
1
UDCA has been used recently in some studies either as adjuvant therapy with IFN or as mono-therapy, in chronic hepatitis C. Puroose of the study : Was to investigate the influence of UDCA in distinct cateaories of oatients with chronic heoatitis C. Material and Mkthods : ‘Forty two patients (m.age 81 years), 14 M and 28 W with chronic heoatitis C were treated with UDCA bOOmg/day for one year. Ten’ patients (group I) had been treated with IFN unsuccessfully in the past while 10 of age > 70 years (group II) and 22 (group Ill) with coexistent diseases (diabetes melitus. cardiopathy, psychiatric diseases) had never been treated. All patients were examined for ALT yGT, ALP, PT every month and for IgG levels and protein electrophoresis evety 3 months. Results : Three out of ten patients of group I (30%), 8 out of 10 of group II (80%) and 15 out of 22 of group Ill (68%) showed normal levels of ALT I-3mo afler the treatment was started and continued to be normal during the whole period of treatment. Among these 26 patients 20 (76%) showed also normal levels of yGT. Prothrombin time, g-globulins and IgG immunoglubulin levels showed a definite improvement but they did not attain in normal levels. ALP levels were found slightly increased before treatment but returned to normal levels soon after. Conclusions : As UDCA was well tolerated could be used as alternative treatment in patients with chronic hepatitis C and age > 70 years as well as in those who cannot be treated with IFN.
Staging scores in the first biopsd showed a more to IFNU
treatment.
THE EFFECT OF ALPHA - 2b - INTERFERON ON PROFILE OF PATIENTS WITH CHRONIC HEPATITIS S. Kanatakis. C. Petroaiannoooulos.’ D. Koutsis. A. Aoelou, A. Zaharof. and A. Moussioni& 3’ and 2”4 Department
of Medicine,
Hellenic
LIPID
Red Cross Hospital.
still remains the main agent for the Alpha - 2b - Interferon treatment of chronic hepatitis B and C having some side effects from many systems. Puroose of the study : Was to investigate if interferon influences the lipides and lipoproteins of patients with chronic hepatitis during one year therapy. Material and methods : We studied 32 patients (m. age 40.7 years), 24 men and 8 women with chronic heyatifis B (8 patients) and C (24 patients) starting therapy with 6.10 Units every second day for hepatitis C and 5.103 Units every second day for hepatitis B. Liver functions tests, HbeAg. HBV-DNA, anti-HCV and lipid profile of all the patients were measured before, during and at the end of one year therapy. Results : From the twenty four patients with hepatitis C eleven (46%) of them had full response while four patients (50%) with hepatitis B did not. As concern as the lipid profile of all the patients total cholesterol (TC) was 204.2 mg% before therapy to 178.8 mg% at the end of therapy, LDL-cholesterol from 139.3 mg% to 125.1 mg%, HDL-cholesterol from 47 mg% to 53.2 mg%, triglycerides from 158.2 mg% to 128,5 mg%, Apoprotein-A from 150.7 mg% to 148.7 mg%, Apoprotein-B from Ill .3 mg% to 98.7 mg% and Lipoprotein-a from 13.6 mg% to 13.4 mg% after one year therapy. Conclusions : Apart the beneficial effects on the liver function tests Alpha - 2b - interferon seems to have a slight beneficial effect on the lipid profile improving all the lipids and lipoproteins parameters.
,VIRAL FACTORS PREDICTING RESPONSE TO INTERFERON ALFA THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C - FOLLOW-UP OF 87 CASES J.J. Staticzak1x2, J. Opoka-Kegler’, J. Baran3, E. Tobolewska’, A. Horbanls3. ‘Hospital for Infectious Diseases, *CD&T AIDS, 31BB PAS, Warsaw, Poland The relation between viral factors (genotype and viral load) and response to Interferon therapy of patients with chronic hepatitis C was estimated. The results of follow-up of 87 patients treated with 3 MU of IFN-alfa trite weekly for 6 months are presented. Methods: HCV genotypes were recognized with INNOLiPA HCV II test (Innogenetic). Serum HCV RNA level was measured by HCV Monitor test (Roche). Results: out of 87 patients in 11 cases la, in 67-lb, , in S-3a and in 4 cases 4c4d genotypes were identified. Baseline serum HCV RNA level varied from 1.2x105 copies/ml (three cases) to 1.8x lo6 (two cases). In 79 cases viral load was in 3.5x105-7.5~10~ range. All patients were followed for 6-24 months (median 14) from the end of treatment. We found 14 cases of sustained response normal ALT level. and undetectable HCV RNA at least 6 months after ending IFN treatment. In this group were 2 patients with la, 7 -lb, 3 -3a and 2 -4c4d genotype. Sustained responders were in group of viral load ranging from 1.2~10~ to 4,6x10’. Conclusion: very high prevalence of HCV genotype 1 in Poland makes viral load more useful viral factor predicting response to IFN therapy comparing to HCV genotype.