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Clinical importance of IgM anti-HCV antibodies in patients with chronic hepatitis C
Viral hepatitis: hzfections, diagnostic procedu,'es, therapy
A RETROSPECTIVE STUDY INTO THE CLINICAL AND DIAGNOSTIC RELEVANCE OF HCV NS-5 ANTIBODY IN PATIENTS WITH CHRONIC HEPATITIS C Giov Squadrito" ~ "", L Powelr, D Brown', A Morris', J van Binsberaen", A Zuckerman" and G Dusheiko'. "Royal Free Hospital School of Medicine, London, England; "Organon Teknika, Boxtel, Holland and ""Dipartimento di Medicine Intarna, University of Messina, Italy. The NS5 region of the hepatitis C virus genome encodes a RNA dependent RNA polymerase which is important for replication of this virus, The clinical and diagnostic relevance of anti-NS5 antibodies is of interest. We have determined the prevalence of anti-NS5
antibodies in gl patients with chronic hepatitis C infection, and 105 controls by enzyme linked immunoassay (EIA) using full length recombinant NS5. Sixty one of 91 (67%) patients with chronic hepatitis C were anti-NS5 positive, compared to 4.7% of controls. HCV RNA was performed by polymerase chain reaction in 29 of 91 patients with chronic hepatitis C (13/91 anti-NS5-positive patients and 16/30 antiNS5 negative), in whom recent samples were available, using primers directed to the NS5 region as well as to the 5'untranslated (5'UT) region. Six of 16 (37.5%) anti-NS5 negative-patients were PCR positive using NS5 region primers, compared to g (56%) who were PCR reactive using primers from the 5'UT region (p = 0.37). Longitudinal samples over a period of 5 years were available in 34/91 chronic HCV positive patients; 23/34 (67.7%) patients were anti-NS5-positive during follow up, 2/34 (5.9%) patients seroconverted to anti-NS5 and another 2/34 (5.9%) patients who were initially positive for anti-NS5 later lost their antibody. There was no correlation between the presence or absence of anti- NS5 and serum transeminase levels. No significant difference was found between the histological stage of the disease and the presence or absence of anti-NS5 antibody. The clinical and diagnositic significance of anti-NS5 antibodies should be examined against viral sequences circulating in patients.
CLINICAL It~ORTANCE OF IgM anti-HCV ANTIBODIES IN PATIENTS WITH CHRONIC HEPATITIS C. J.Str~nsk@,E.Honz~kov~,J.Vandasov~,Z.Mandakov~, Dept.of H e p a t o l o g y and Virology, Fac.Hosp.Bulovka, P r a g u e , C z e c h Republic. In chronic hepatitis C (CHC) serum IgM antiHCV correlates with ongoing viral replication and active liver disease. AIH of thisstudy was to assess the c o r r e l a t i o n b e t w e e n the p o s i t i v i t y of IgM a n t i - H C V in patients w i t h CHC, CH HBsAg negative and excluded blood donors. METHODS: During a 3mo study period serum specimen of 88 u n t r e a t e d patients were e x a m i n e d for IgG a n t i - H C V by M o n o l i s a Sanofi Pasteur and IgM a n t i - H C V by E I A Abbott. 47 patients had h i s t o l o g i c a l examination. Based on the results of serological examination patients were d i v i d e d into 3 groups: i. positive IgG and IgM anti-HCV, 2. positive anti-HCV only, 3.both markers negative. RESULTS: Mean age, t r a n s a m i n a s e activity and h i s t o l o g i c a l findings are in the table : cut-off G N Age ALT AST anti-HCV CI + CAH % 1 24 55 1.98 1.43 2.452 10 6 67 2 38 46 1.30 1.08 2.160 7 5 32 3 26 43 1.01 0.81 4 1 19 CONCLUSION: Patients w i t h p o s i t i v e IgM antiHCV had a more severe h i s t o l o g i c a l finding in the liver, s i g n i f i c a n t l y higher ALT activity, higher mean cut-off p o s i t i v i t y and were older than patients w i t h o u t IgM.
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SHORT VERSUS PROLONGED COURSE OF CORTICOSTEROID THERAPY IN CHRONIC LIVER DISEASES HCV CORRELATED. O. Taramino, L Morel~ G. Schipm~ N. Modando. Imtilme of Imenud . ~ 4 ~ , . and Di~*aboli~ Diseases, U~ver.Aty of Napier "Fededco I ~ Italy, Our lxeviooa smdi~ have ~ o w n a 2rid cyde of IFN therapy in n m ~ pcs to be ofeay mility. Them am new i a ~ , - ~ S &t~ about the ~ . ~ a~ion of C virus =rid ~ as~:iafioe with ~-,vend e u W ; m ~ ~ Oathe be.~ of this ~ we ~ 18 1~ (13 F) mean sSe 56,1 -i- 8.7 with cl~cal, bi~.h,-~cal and ~ l o s i c a l (101~) rma~.Ss of poettzpefit~ C liver ~ (reject: 8 t ~ with liver c i n t x ~ - - a l0 t ~ with CAH + c i ~ t x ~ ) . Our pts 8ho ~ , - a clinical end/or bio,-h-~eal evidence of a.~odaxed ;...... ~olosicaJ and metabolic diso~den: 2 pcs w~e AMS po~; 2 l ~ ~owed the presence of ~ cryoelobelim; 8 pe were Waler-Ro~ (WR) mxJ/or PCR po~; 2 p~ bad diabe~; I pC ,bowed a ~ c o ~ r y R~yemed',
pheaom~oe and 3 pts bad I;chen(ot,-t of these I pc al..ma peoda..~s).All of these p~ received two or mo~e IFN cydes with no rcspom~ lyre were m b d i v ~ d in two Sroepe: I ~ m ~ A _ _ ( S l ~ ) ~ . a with aloes term ,~m~n~rlfion of ~ i d thera~ (D*,fl~,~-oft) ~hedule: 20 m8 oe on slt. days fo~ a ~ of 1~0 ± 16 days and Stoop B (1O pcs) ~mated with dx~tterm therapy ~ * o e e ) schedul~ 60, 40, 20 m s oe/die, every two weeks 8radually reduced. In group A: pts mean ALT x n.y. be/ore and after ~ y w ~ e 2,6 ± 1,14 and 1.9 ± 0,7 (t - 1,59; p > 0,05) reepec~ in JE99P_~; 2,8 _+ 0,97 8rid 2,1 -+ 0,82 (t = 1,93; p > 0,05). IgG levels decreased in Stoup A I ~ (1955 ± 320 m~dl before ther@y 'n 1344 • Io6 ms/dl e/ter ~ ) ~ in group B im respect (2065 + 2 8 0 ' ~ 1900-+ 188). At the end ofthe~ey amoa8 13 pcs which we had a follow up pe~od of about 45 days 10 pcs who had ~ we had to ia~ease im'ulin doee; 3 p~ required for the fir~ time an in~lia then@y, I pthad ~ cysd~ and I pt withhypemmsionrequiredm kx:rease dose of dru& We fouad also ia all pts a ~ in bio~'tw,mi~l rod/or ,q;-;.,,~ b,m,-,qoSicalend metabolicdiseMesdurin8corticoetesoid therapy(respea:a decreases tide in At,IS, WR aM PCR; a ai~,,pearm~ of serum orySlobalim; and a more rare o c a a m ~ of symptoms) in pc with Rayuzad's ~ and in pts with de,,~.losical di.sea~. Ia c o ~ u s i o a , alflmugh a Sreat deal of evideme .,¢.~ly, exist that C virus plays m ~ role, the ~ therapy of ch~mi~ live~ di~Mes HCV co~elsted nee& further .~*,,~ve ~tudies.
COMPARATIVE EFFICACY OF HIGH AND LOW DOSE OF INTERFERON ALFA IN CHRONIC HEPATITISC: A RANDOMIZED TRIAL l~Zs~s.soooulos*. G. Karvountzis**. G. Touloumi***. I. DJ~lladetsJm.a~**: G. Pap~d'heodoridis*: I. Iosilantis**,_~ ~ab.~kls . First Dept. o} Medicine, Western Attica Gen. Hospital, **State Dept. of Meedicine, Hippokration Gen. Hospital, • **Dept. of Hygiene and Epidemiology, Athens University Medical School, ****Dept. of Pathology, Laikon Gen. Hospital, Athens, Greece Fiftly eight patients (41 males, 17 females) with chronic hepatitis C were randomly assigned to treatment with either 10 million (n=28) or 3 million units In=30) of recombinant interferon alfa-2b (IFNa) thrice weekly for 26 weeks. Follow-up after the end of treatment was 26 weeks. Response was defined as complete (CR=ALT normal) or near-complete (NCR=ALT decreased to
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A RETROSPECTIVE STUDY INTO THE CLINICAL AND DIAGNOSTIC RELEVANCE OF HCV NS-5 ANTIBODY IN PATIENTS WITH CHRONIC HEPATITIS C Giov Squadrito" ~ "", L Powelr, D Brown', A Morris', J van Binsberaen", A Zuckerman" and G Dusheiko'. "Royal Free Hospital School of Medicine, London, England; "Organon Teknika, Boxtel, Holland and ""Dipartimento di Medicine Intarna, University of Messina, Italy. The NS5 region of the hepatitis C virus genome encodes a RNA dependent RNA polymerase which is important for replication of this virus, The clinical and diagnostic relevance of anti-NS5 antibodies is of interest. We have determined the prevalence of anti-NS5
antibodies in gl patients with chronic hepatitis C infection, and 105 controls by enzyme linked immunoassay (EIA) using full length recombinant NS5. Sixty one of 91 (67%) patients with chronic hepatitis C were anti-NS5 positive, compared to 4.7% of controls. HCV RNA was performed by polymerase chain reaction in 29 of 91 patients with chronic hepatitis C (13/91 anti-NS5-positive patients and 16/30 antiNS5 negative), in whom recent samples were available, using primers directed to the NS5 region as well as to the 5'untranslated (5'UT) region. Six of 16 (37.5%) anti-NS5 negative-patients were PCR positive using NS5 region primers, compared to g (56%) who were PCR reactive using primers from the 5'UT region (p = 0.37). Longitudinal samples over a period of 5 years were available in 34/91 chronic HCV positive patients; 23/34 (67.7%) patients were anti-NS5-positive during follow up, 2/34 (5.9%) patients seroconverted to anti-NS5 and another 2/34 (5.9%) patients who were initially positive for anti-NS5 later lost their antibody. There was no correlation between the presence or absence of anti- NS5 and serum transeminase levels. No significant difference was found between the histological stage of the disease and the presence or absence of anti-NS5 antibody. The clinical and diagnositic significance of anti-NS5 antibodies should be examined against viral sequences circulating in patients.
CLINICAL It~ORTANCE OF IgM anti-HCV ANTIBODIES IN PATIENTS WITH CHRONIC HEPATITIS C. J.Str~nsk@,E.Honz~kov~,J.Vandasov~,Z.Mandakov~, Dept.of H e p a t o l o g y and Virology, Fac.Hosp.Bulovka, P r a g u e , C z e c h Republic. In chronic hepatitis C (CHC) serum IgM antiHCV correlates with ongoing viral replication and active liver disease. AIH of thisstudy was to assess the c o r r e l a t i o n b e t w e e n the p o s i t i v i t y of IgM a n t i - H C V in patients w i t h CHC, CH HBsAg negative and excluded blood donors. METHODS: During a 3mo study period serum specimen of 88 u n t r e a t e d patients were e x a m i n e d for IgG a n t i - H C V by M o n o l i s a Sanofi Pasteur and IgM a n t i - H C V by E I A Abbott. 47 patients had h i s t o l o g i c a l examination. Based on the results of serological examination patients were d i v i d e d into 3 groups: i. positive IgG and IgM anti-HCV, 2. positive anti-HCV only, 3.both markers negative. RESULTS: Mean age, t r a n s a m i n a s e activity and h i s t o l o g i c a l findings are in the table : cut-off G N Age ALT AST anti-HCV CI + CAH % 1 24 55 1.98 1.43 2.452 10 6 67 2 38 46 1.30 1.08 2.160 7 5 32 3 26 43 1.01 0.81 4 1 19 CONCLUSION: Patients w i t h p o s i t i v e IgM antiHCV had a more severe h i s t o l o g i c a l finding in the liver, s i g n i f i c a n t l y higher ALT activity, higher mean cut-off p o s i t i v i t y and were older than patients w i t h o u t IgM.
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SHORT VERSUS PROLONGED COURSE OF CORTICOSTEROID THERAPY IN CHRONIC LIVER DISEASES HCV CORRELATED. O. Taramino, L Morel~ G. Schipm~ N. Modando. Imtilme of Imenud . ~ 4 ~ , . and Di~*aboli~ Diseases, U~ver.Aty of Napier "Fededco I ~ Italy, Our lxeviooa smdi~ have ~ o w n a 2rid cyde of IFN therapy in n m ~ pcs to be ofeay mility. Them am new i a ~ , - ~ S &t~ about the ~ . ~ a~ion of C virus =rid ~ as~:iafioe with ~-,vend e u W ; m ~ ~ Oathe be.~ of this ~ we ~ 18 1~ (13 F) mean sSe 56,1 -i- 8.7 with cl~cal, bi~.h,-~cal and ~ l o s i c a l (101~) rma~.Ss of poettzpefit~ C liver ~ (reject: 8 t ~ with liver c i n t x ~ - - a l0 t ~ with CAH + c i ~ t x ~ ) . Our pts 8ho ~ , - a clinical end/or bio,-h-~eal evidence of a.~odaxed ;...... ~olosicaJ and metabolic diso~den: 2 pcs w~e AMS po~; 2 l ~ ~owed the presence of ~ cryoelobelim; 8 pe were Waler-Ro~ (WR) mxJ/or PCR po~; 2 p~ bad diabe~; I pC ,bowed a ~ c o ~ r y R~yemed',
pheaom~oe and 3 pts bad I;chen(ot,-t of these I pc al..ma peoda..~s).All of these p~ received two or mo~e IFN cydes with no rcspom~ lyre were m b d i v ~ d in two Sroepe: I ~ m ~ A _ _ ( S l ~ ) ~ . a with aloes term ,~m~n~rlfion of ~ i d thera~ (D*,fl~,~-oft) ~hedule: 20 m8 oe on slt. days fo~ a ~ of 1~0 ± 16 days and Stoop B (1O pcs) ~mated with dx~tterm therapy ~ * o e e ) schedul~ 60, 40, 20 m s oe/die, every two weeks 8radually reduced. In group A: pts mean ALT x n.y. be/ore and after ~ y w ~ e 2,6 ± 1,14 and 1.9 ± 0,7 (t - 1,59; p > 0,05) reepec~ in JE99P_~; 2,8 _+ 0,97 8rid 2,1 -+ 0,82 (t = 1,93; p > 0,05). IgG levels decreased in Stoup A I ~ (1955 ± 320 m~dl before ther@y 'n 1344 • Io6 ms/dl e/ter ~ ) ~ in group B im respect (2065 + 2 8 0 ' ~ 1900-+ 188). At the end ofthe~ey amoa8 13 pcs which we had a follow up pe~od of about 45 days 10 pcs who had ~ we had to ia~ease im'ulin doee; 3 p~ required for the fir~ time an in~lia then@y, I pthad ~ cysd~ and I pt withhypemmsionrequiredm kx:rease dose of dru& We fouad also ia all pts a ~ in bio~'tw,mi~l rod/or ,q;-;.,,~ b,m,-,qoSicalend metabolicdiseMesdurin8corticoetesoid therapy(respea:a decreases tide in At,IS, WR aM PCR; a ai~,,pearm~ of serum orySlobalim; and a more rare o c a a m ~ of symptoms) in pc with Rayuzad's ~ and in pts with de,,~.losical di.sea~. Ia c o ~ u s i o a , alflmugh a Sreat deal of evideme .,¢.~ly, exist that C virus plays m ~ role, the ~ therapy of ch~mi~ live~ di~Mes HCV co~elsted nee& further .~*,,~ve ~tudies.
COMPARATIVE EFFICACY OF HIGH AND LOW DOSE OF INTERFERON ALFA IN CHRONIC HEPATITISC: A RANDOMIZED TRIAL l~Zs~s.soooulos*. G. Karvountzis**. G. Touloumi***. I. DJ~lladetsJm.a~**: G. Pap~d'heodoridis*: I. Iosilantis**,_~ ~ab.~kls . First Dept. o} Medicine, Western Attica Gen. Hospital, **State Dept. of Meedicine, Hippokration Gen. Hospital, • **Dept. of Hygiene and Epidemiology, Athens University Medical School, ****Dept. of Pathology, Laikon Gen. Hospital, Athens, Greece Fiftly eight patients (41 males, 17 females) with chronic hepatitis C were randomly assigned to treatment with either 10 million (n=28) or 3 million units In=30) of recombinant interferon alfa-2b (IFNa) thrice weekly for 26 weeks. Follow-up after the end of treatment was 26 weeks. Response was defined as complete (CR=ALT normal) or near-complete (NCR=ALT decreased to
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