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Analysis of hepatitis B virus (HBV) genomic variability in the pre-C region
55 EFFECTS OF PROPRANOLOL (Prop) AND PLACEBO (Pla) ON OESOPHAGEAL VARICEAL PRESSURE (OVP) IN CIRRHOSIS. F Feu. JM Bordas, JC Garcia-Paa6n. J Bosch. J Rod& Liver Unit, Hospital Clinic, Univ of Barcelona. The effects of Prop on @!P have not been studied The present study examined this issue by so far. measurino the chanaes in OVP in 20 patients with portal Hypertension studied prior anb 15 min after the double blind administration of Prop (0.15 mg/Kg iv. n=lO) or Pla (n=lO). OVP was measured at endoscopy using a miniaturised pressure gauge. In addiin 17 pts (8 Prop, 9 Pla) the effects on tion, portal pressure (PP) and azygos blood flow (ABF) were also determined. OVP was similar in Prop and Pla On baseline. groups (14.lfS vs 14.9k6.6 mmHg). Pla had no effect ;;)OVP (mean change 5.5%. NS). PP (-1.5%) or ABF (On the contrary, Prop Tarkedly decreased OVP (to'11.3f4.4 mmHg, :tn C:). PP (-12%. p
ENDOSCOPIC MEASUREMENT OF VARICEAL PRESSURE (VP) IN PATIENTS WITH CIRRHOSIS. CORRELATION WITH THE NIEC INDEX (NI) AND WITH THE RISK OF VARICEAL HEMORRHAGE F Feu, JM Bordas. JC Garcia-Paq6n. J Bosch, J Rod&s Liver Unit, Hospital Clinic, Univ of Barcelona. In oatients with cirrhosis. liver failure (Child Pugh).'size of varices. and red wale markings‘(RWMj are independent predictors of the risk of variceal bleeding (VH). These are combined in the NI. It has been siggested that endoscopic measurements of VP and wall tension index (WTI. VP x site varix1 mav have predictive value. ihe present study inv&.t~~ gated the relationship between NI and VP and WTI in 47 pts with portal hypertension. The relationship between these and risk of VH was assessed in 21 pts who had repeat measurements on follow-up. VP was measured using a miniaturised pressure gauge. Only reproducible. unartefacted tracings uere evaluated. Measurements of VP and WTI co&elated with size of varices and NI. but not with Child-Puah class or presence of RWM. In pts with vat-ices S-mm VP was lZa4 mmHg vs l&6 in pts with big varices (p<.O5). Similarly, patients with NI below median (27.1) had lower VP and WTI than those with high NI (VP 13f4.8 vs 17.4+6 mmHg. WTI 45r27 YS B6+64 mmHg.mm: pt.01). on follow-up, 5 of 21 pts developed VW. They maintained higher VP (19i4 vs 11*4. p<.OOZ). WTI (93+35 vs 4h26. pc.005) and NI (31.4t4 vs 24.W. pt.01) than non-bleeders. All bleeders had VP 15. WTI 60 and NI 27. In non-bleeders. only 3 had VP 15 and 2 WTI 60 (p<.OO5). but 7 had NI 27 (~~05). This study suggests that endoscopic measurements of VP may provide additional and useful prognostic data on the risk of VH in portal hypertension.
01 LWLLYSISOF HEPATITIS B VIRUS (HBV)
88
GtWOlllC VARIABILIIY I" THE
PRE-CREGIO" A.Floreani*.M.Chiaramonte*,S.Giannini.L.~alvasi, -__-A.Giacomini*.A.D'A,,,elo. R.NaccaraJq'?? CQtofs enterology,Inst.Int.Mtd.,Universityofpada (Italy)
G.Fiord~lisi.E.Cariani.G.~antero.A.Zanetti~.D.Pri~i Consorzio
per
Ir Giotecnologir.
Brcscia.
Italy.
Olstituto
di
Yirelogia. Uriversita' di Milan0 A subset despite
of
chronic
nrga:ivity
HBV
for
carriers
HBeAg.
A
dirplays
stop
codon
serum
WV
A 12 month pilot
DNA
preventing
nmecutive
synthesis h2s recently been observed in the pre-C region of HBV in these rl;bjects. This observation suggests the existence of a distinct HSY s:rain responsible far anti-We. chronic hepaciiis. In the present study.
HGV DNA positive
serm
sampler
fran 11
anti-Hfle. HGV 04A positive HSV carriers with liver disease ue~e studied
by
PCR
using
primers
spanning
the
pre-C/C
region.
clones
revealed
Nucleotide sequence analysis of 25 independent that the pre-C sequence was highly derived fron the sane subject. to
affect
H9eAg
substitutions synthesis:
synthesis.
predictably
variable.
Several
Houever. leading
1) the already reported
even among
mutations de
to
lack
region.
clones from 16 patients. and 21 a T-C mutation stvt
codon
of
prc-C.
observed
in
2
clones
patient. Our data support a high frequency prr-C region of HBV. rather
of
G-A substitution
in a stop codon at the end of the pm-C
clones
did not seen
observed t"O the
resulting in 18
eliminating from
the
of mutations
than the existence
bare HSeAg
observed
of
a
the same
in the specific
HEV variant
.erponsible 6~ anti-1Ec. HBV DNA positive chronic
hepatitis.
Sow
wtarions
are
probably
segregated
due
study
was
carried
out in 24
fenale PBC pts (10pread14 pcstmsrpar;al). The pts were allocated into 2 -aoxdirgto the sewri~ofbcnelcssassasedbybalphDtma!xqtiaretryof the lumbar spine: A: no treatment (11 ptstitiaverage area1 density (AADPO.800 g/cm*; 9) treatment (13 pts with AADC0.900). FfiWlWX oral l.ZS(OH)~vitD (O.SpS twiceachy for 5 days) followed by a week co"~se with oral Ca carba?ate (l%Jnp~ly)+cart-lci~ nin (43Umc) i.m. thrice weekly. The treatmentwas repeated after 2 month interval for 12 months. We assessed before and at the end of the study: Cd,M, K, tQ. Cl, c~eatininz,PO4 (in bleedad u-ire), 29% vitD. 1.25 (al)vit D. W-proiine. Plli, asteocalcin End*iiometry. RESULTS: After 12 months AAD was significantly reduced in the untreated (&s-4.93*8)as compared to the treated pts &0.%_7), ptO.06); OHProline e%CretiO"was significantlyreduced in ~cap B compared to group A (p
HBeAg
to
selective host pressure.
s22
ENDOSCOPIC MEASUREMENT OF VARICEAL PRESSURE (VP) IN PATIENTS WITH CIRRHOSIS. CORRELATION WITH THE NIEC INDEX (NI) AND WITH THE RISK OF VARICEAL HEMORRHAGE F Feu, JM Bordas. JC Garcia-Paq6n. J Bosch, J Rod&s Liver Unit, Hospital Clinic, Univ of Barcelona. In oatients with cirrhosis. liver failure (Child Pugh).'size of varices. and red wale markings‘(RWMj are independent predictors of the risk of variceal bleeding (VH). These are combined in the NI. It has been siggested that endoscopic measurements of VP and wall tension index (WTI. VP x site varix1 mav have predictive value. ihe present study inv&.t~~ gated the relationship between NI and VP and WTI in 47 pts with portal hypertension. The relationship between these and risk of VH was assessed in 21 pts who had repeat measurements on follow-up. VP was measured using a miniaturised pressure gauge. Only reproducible. unartefacted tracings uere evaluated. Measurements of VP and WTI co&elated with size of varices and NI. but not with Child-Puah class or presence of RWM. In pts with vat-ices S-mm VP was lZa4 mmHg vs l&6 in pts with big varices (p<.O5). Similarly, patients with NI below median (27.1) had lower VP and WTI than those with high NI (VP 13f4.8 vs 17.4+6 mmHg. WTI 45r27 YS B6+64 mmHg.mm: pt.01). on follow-up, 5 of 21 pts developed VW. They maintained higher VP (19i4 vs 11*4. p<.OOZ). WTI (93+35 vs 4h26. pc.005) and NI (31.4t4 vs 24.W. pt.01) than non-bleeders. All bleeders had VP 15. WTI 60 and NI 27. In non-bleeders. only 3 had VP 15 and 2 WTI 60 (p<.OO5). but 7 had NI 27 (~~05). This study suggests that endoscopic measurements of VP may provide additional and useful prognostic data on the risk of VH in portal hypertension.
01 LWLLYSISOF HEPATITIS B VIRUS (HBV)
88
GtWOlllC VARIABILIIY I" THE
PRE-CREGIO" A.Floreani*.M.Chiaramonte*,S.Giannini.L.~alvasi, -__-A.Giacomini*.A.D'A,,,elo. R.NaccaraJq'?? CQtofs enterology,Inst.Int.Mtd.,Universityofpada (Italy)
G.Fiord~lisi.E.Cariani.G.~antero.A.Zanetti~.D.Pri~i Consorzio
per
Ir Giotecnologir.
Brcscia.
Italy.
Olstituto
di
Yirelogia. Uriversita' di Milan0 A subset despite
of
chronic
nrga:ivity
HBV
for
carriers
HBeAg.
A
dirplays
stop
codon
serum
WV
A 12 month pilot
DNA
preventing
nmecutive
synthesis h2s recently been observed in the pre-C region of HBV in these rl;bjects. This observation suggests the existence of a distinct HSY s:rain responsible far anti-We. chronic hepaciiis. In the present study.
HGV DNA positive
serm
sampler
fran 11
anti-Hfle. HGV 04A positive HSV carriers with liver disease ue~e studied
by
PCR
using
primers
spanning
the
pre-C/C
region.
clones
revealed
Nucleotide sequence analysis of 25 independent that the pre-C sequence was highly derived fron the sane subject. to
affect
H9eAg
substitutions synthesis:
synthesis.
predictably
variable.
Several
Houever. leading
1) the already reported
even among
mutations de
to
lack
region.
clones from 16 patients. and 21 a T-C mutation stvt
codon
of
prc-C.
observed
in
2
clones
patient. Our data support a high frequency prr-C region of HBV. rather
of
G-A substitution
in a stop codon at the end of the pm-C
clones
did not seen
observed t"O the
resulting in 18
eliminating from
the
of mutations
than the existence
bare HSeAg
observed
of
a
the same
in the specific
HEV variant
.erponsible 6~ anti-1Ec. HBV DNA positive chronic
hepatitis.
Sow
wtarions
are
probably
segregated
due
study
was
carried
out in 24
fenale PBC pts (10pread14 pcstmsrpar;al). The pts were allocated into 2 -aoxdirgto the sewri~ofbcnelcssassasedbybalphDtma!xqtiaretryof the lumbar spine: A: no treatment (11 ptstitiaverage area1 density (AADPO.800 g/cm*; 9) treatment (13 pts with AADC0.900). FfiWlWX oral l.ZS(OH)~vitD (O.SpS twiceachy for 5 days) followed by a week co"~se with oral Ca carba?ate (l%Jnp~ly)+cart-lci~ nin (43Umc) i.m. thrice weekly. The treatmentwas repeated after 2 month interval for 12 months. We assessed before and at the end of the study: Cd,M, K, tQ. Cl, c~eatininz,PO4 (in bleedad u-ire), 29% vitD. 1.25 (al)vit D. W-proiine. Plli, asteocalcin End*iiometry. RESULTS: After 12 months AAD was significantly reduced in the untreated (&s-4.93*8)as compared to the treated pts &0.%_7), ptO.06); OHProline e%CretiO"was significantlyreduced in ~cap B compared to group A (p
HBeAg
to
selective host pressure.
s22