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Hepatitis “C” virus antibody (anti-HCV) prevalence in psoriasis
Viral hepatitis," infections, diagnostic procedures, therapy
VIRAL LOAD OF HCV RNA IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH IFN ALPHA MO Ercilla. JM Barrera. M Oonzalez, V Onorato, R Celis, M Brognera, J Rodes. Immunology Dept, Liver Unit, Blood Bank, Hospital Clinic, University of Barcelona. Spain. Interferon alfa (a-IFN) has been proposed as an effective treatment for controlling disease activity in chronic hepatitis C patients. However only some patients benefits of a sustained respouso. Objectives: To determine the hepatitis virus C load by a quantitative method (branched DNA signal amplification, bDNA Chiton Co) in predicting response to antiviral therapy in chronic hepatitis C patients. Methods: Twenty two patients were followed for a mean of 14 months prior to having IFN treatment. All were HCV-RNA positive in serum by nested PCR method using primers of the 5' NC region. A liver biopsy was performed prior to the treatment in all patients and in 6 patients after ending the treatment. All patients received 3-5 MU alfa 2 INF three times a week for 12 months. Patients were followed up for a mean of 11 months after ending the treatment. According to the ALT levels, patients were divided in three groups: Seven had a sustained complete response (SR), Complete response with relapse (CRR) after the drug was stopped in 5 and 10 non-responders (NR). HCV-RNA quantification was carried out at entry, at the end of treatment and at the end-time of control. Results: Five patients initially had below detectable levels of HCV-RNA by bDNA assay (3,5x105 equivalents/ml) and 4 (80%) has a SR and one bad a CRR. Among the 7 patients with HCV-RNA levels between 3,520x105 eq/ml, 3 have a SR and 1 CRR. Among the nine patients loading 2-50 x l 0 ~ eq/ml, only 2 had a CRR, however the viremia decreased by I0" or 10"2 in 6 patients during treatment. The histology was improved after the treatment in four patients with sustainedresponse. Conclusion: These results suggest that the HCV-RNA load is a very important factor influencing the sustained response to interferon.
EFFECT OF A 24 MONTH ALPHA IFN TREATMENT IN HCV CHRONIC HEPATITIS F.M.Felaco, L.Aprea, V.Messina, P.Filippini, E.Sa~qlelli, F.Piccinino. Institute of Tropical Diseases 2 ° University of Naples, Italy. We evaluated the long-term efficacy and complia_n ce of a 24 mouth alpha IFN treatment in 60 chronic hepatitis patients (20 CPH, 40 CAH) consecutively assigned to receive either 1.5 MU or 3 MU or 6 MU of lymphoblastoid IFN,tiw im. Treatment had to be dlscontlnued because of side effects only in 2 patients in 1.5 MU and 6 MU groups. The 6 MU dose had to be halved after 3 months because of h~uvy lelght loss in 3 patients and of insomnia in one. At the end of treatment normalization of ALT was observed in 47% of patients in the group on 1.5 MU, in 68.4% of those on 3 MU, and in 64.2% in the group on 6 MU. Twelve months after discontinuation of treatment, ALT values were still normal (sustained response)in 23.5% of patients treated with 1.5 MU, in 52.6% and is 50% of those treated with 3 MU ore 6 MU, respectively. The results indicate that a 24 month treatment at 3 or 6 MU doses induces a sustained response more frequently than shorter treatments. 3 MIJ of IFN is as effective as 6 MU but is better tolerated. The 1.5 MU dose in a 24 month treatment is less effective and should be considered only for patients who may sot tolerate an higher dose.
S 105
PREVALENCE OF HCV RNA BY NESTED PCR (RTn-PCR) IN AUTOIMMUNE HEPATITIS TYPE-1 (AH-1). 3. F i n d o r , 3. D a r u i c h , E. Bruch IqartOa, A. S h i j m a n n , P. Herrmann, 3. Sord&, E. Manero. H o s p i t a l de C l i n i c a s , U n i v e r s i t y of Buenos Aires, Buenos Aires, Argentina. BACKGROUND: The p r e v a l e n c e o f anti-HCV i n AH-1 i s s t i l l a matter of controversy and s t u d i e s i n c l u d i n g the search of HCV RNA i n serum a r e s c a r c e . OB3ECTIVE: To s t u d y t h e p r e v a l e n c e o f HCV RNA i n AH-1. MATERIAL AND METHODS: b9 p t s w i t h AH-1 were e n r o l l e d i n t h i s s t u d y . Only those with positive SMA o r ANA a t titer 1/80, gammaglobulin ~ 2 g/L and diagnosis c o n f i r m e d by histology, were i n c I u d e d . Search f o r HCV RNA b y RTn-PCR usxng met oding region and a nti ~V pr*b y 5"non c ELISA II (Abbott) were performed in all pts. RESULTS: 59 p t s (85.5M) were female, the m e a n age was 41.5 (min 12, max 76), extrahepatic manifestation were present in 22 ( 3 1 . 9 % ) . H C V - RNA was d e t e c t e d i n b pts (8.7M). A l l o f them were a l s o positive for anti H C V . From 62 pts followed for sufficient time, 54 (87.2%) had good response t o immunosuppressive t h e r a p y . All pts positive for HCV RNA were also good responders to this treatment. CONCLUSIONS: The prevalence of HCV markers i n AH-1 i s very low, even when highly sensitive methodology i s used. The good response t o corticosteroid therapy also in those w i t h a n t i HCV and HCV-RNA f a v o r s the opinion that viral infection is probably s u p e r i m p o s e d on p r e e x i s t i n g AH-1.
HEPATITIS "C" PREVALENCE IN
VIRUS ANTIBODY PSORIASIS.
(ANTI-HCV)
B.Frider, S~ Sookoian, J.Panetta, M.Kina, F__~. V e y r e t o u , G__~. C a s t a ~ o a n d E. C h o u e l a . Internal Medicine-Hepatology, Serology and Dermatology Units. Argerich Hospital,Univ. of Buenos Aires. Argentina In s o m e p a t i e n t s with psoriasis {PS) the etiology of underlying liver disease is unknown. To i n v e s t i g a t e t h e p r e v a l e n c e o f a n t i - H C V and i t s clinical significance, 118 u n s e l e c t e d o u t p a t i e n t s with PS were studied prospectively. As c o n t r o l , the i.2% a n t i - H C V p r e v a l e n c e i n 60.000 d o n o r s was t a k e n . Nine o u t o f I18 samples (7.6%) p r o v e d p o s i t i v e by E l i s a I I w i t h a OD =/>3 by d o u b l e d e t e r m i n a t i o n (p < O.OOi). There were no d i f f e r e n c e s between a n t i - H C V + / as r e g a r d g e n d e r , a g e , h i s t o r y o f h e p a t i t i s and p r i o r treatment with methotrexate or etretinate. A n t i - H B c were (+) i n 17 {i5%) s a m p l e s . L i v e r b i o p s y i n a n t i - H C V ( + ) oases showed 4 Chronic active Hepatitis, 1 cirrhosis and i e s t h e a t o s i s . The high anti-HCV p r e v a l e n c e in this series is attributable t o i n f e c t i o n by i n n a p p a r e n t p a r e n t e r a I r o u t e s , as r e p o r t e d f o r HBV i n PS t h r o u g h m i n u t e s k i n a b r a s i o n s . In t h e p r e s e n c e o f l i v e r d i s e a s e i n PS p a t i e n t s , HCV i n f e c t i o n s h o u l d t h u s be c o n s i d e r e d as an alternative diagnosis.
VIRAL LOAD OF HCV RNA IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH IFN ALPHA MO Ercilla. JM Barrera. M Oonzalez, V Onorato, R Celis, M Brognera, J Rodes. Immunology Dept, Liver Unit, Blood Bank, Hospital Clinic, University of Barcelona. Spain. Interferon alfa (a-IFN) has been proposed as an effective treatment for controlling disease activity in chronic hepatitis C patients. However only some patients benefits of a sustained respouso. Objectives: To determine the hepatitis virus C load by a quantitative method (branched DNA signal amplification, bDNA Chiton Co) in predicting response to antiviral therapy in chronic hepatitis C patients. Methods: Twenty two patients were followed for a mean of 14 months prior to having IFN treatment. All were HCV-RNA positive in serum by nested PCR method using primers of the 5' NC region. A liver biopsy was performed prior to the treatment in all patients and in 6 patients after ending the treatment. All patients received 3-5 MU alfa 2 INF three times a week for 12 months. Patients were followed up for a mean of 11 months after ending the treatment. According to the ALT levels, patients were divided in three groups: Seven had a sustained complete response (SR), Complete response with relapse (CRR) after the drug was stopped in 5 and 10 non-responders (NR). HCV-RNA quantification was carried out at entry, at the end of treatment and at the end-time of control. Results: Five patients initially had below detectable levels of HCV-RNA by bDNA assay (3,5x105 equivalents/ml) and 4 (80%) has a SR and one bad a CRR. Among the 7 patients with HCV-RNA levels between 3,520x105 eq/ml, 3 have a SR and 1 CRR. Among the nine patients loading 2-50 x l 0 ~ eq/ml, only 2 had a CRR, however the viremia decreased by I0" or 10"2 in 6 patients during treatment. The histology was improved after the treatment in four patients with sustainedresponse. Conclusion: These results suggest that the HCV-RNA load is a very important factor influencing the sustained response to interferon.
EFFECT OF A 24 MONTH ALPHA IFN TREATMENT IN HCV CHRONIC HEPATITIS F.M.Felaco, L.Aprea, V.Messina, P.Filippini, E.Sa~qlelli, F.Piccinino. Institute of Tropical Diseases 2 ° University of Naples, Italy. We evaluated the long-term efficacy and complia_n ce of a 24 mouth alpha IFN treatment in 60 chronic hepatitis patients (20 CPH, 40 CAH) consecutively assigned to receive either 1.5 MU or 3 MU or 6 MU of lymphoblastoid IFN,tiw im. Treatment had to be dlscontlnued because of side effects only in 2 patients in 1.5 MU and 6 MU groups. The 6 MU dose had to be halved after 3 months because of h~uvy lelght loss in 3 patients and of insomnia in one. At the end of treatment normalization of ALT was observed in 47% of patients in the group on 1.5 MU, in 68.4% of those on 3 MU, and in 64.2% in the group on 6 MU. Twelve months after discontinuation of treatment, ALT values were still normal (sustained response)in 23.5% of patients treated with 1.5 MU, in 52.6% and is 50% of those treated with 3 MU ore 6 MU, respectively. The results indicate that a 24 month treatment at 3 or 6 MU doses induces a sustained response more frequently than shorter treatments. 3 MIJ of IFN is as effective as 6 MU but is better tolerated. The 1.5 MU dose in a 24 month treatment is less effective and should be considered only for patients who may sot tolerate an higher dose.
S 105
PREVALENCE OF HCV RNA BY NESTED PCR (RTn-PCR) IN AUTOIMMUNE HEPATITIS TYPE-1 (AH-1). 3. F i n d o r , 3. D a r u i c h , E. Bruch IqartOa, A. S h i j m a n n , P. Herrmann, 3. Sord&, E. Manero. H o s p i t a l de C l i n i c a s , U n i v e r s i t y of Buenos Aires, Buenos Aires, Argentina. BACKGROUND: The p r e v a l e n c e o f anti-HCV i n AH-1 i s s t i l l a matter of controversy and s t u d i e s i n c l u d i n g the search of HCV RNA i n serum a r e s c a r c e . OB3ECTIVE: To s t u d y t h e p r e v a l e n c e o f HCV RNA i n AH-1. MATERIAL AND METHODS: b9 p t s w i t h AH-1 were e n r o l l e d i n t h i s s t u d y . Only those with positive SMA o r ANA a t titer 1/80, gammaglobulin ~ 2 g/L and diagnosis c o n f i r m e d by histology, were i n c I u d e d . Search f o r HCV RNA b y RTn-PCR usxng met oding region and a nti ~V pr*b y 5"non c ELISA II (Abbott) were performed in all pts. RESULTS: 59 p t s (85.5M) were female, the m e a n age was 41.5 (min 12, max 76), extrahepatic manifestation were present in 22 ( 3 1 . 9 % ) . H C V - RNA was d e t e c t e d i n b pts (8.7M). A l l o f them were a l s o positive for anti H C V . From 62 pts followed for sufficient time, 54 (87.2%) had good response t o immunosuppressive t h e r a p y . All pts positive for HCV RNA were also good responders to this treatment. CONCLUSIONS: The prevalence of HCV markers i n AH-1 i s very low, even when highly sensitive methodology i s used. The good response t o corticosteroid therapy also in those w i t h a n t i HCV and HCV-RNA f a v o r s the opinion that viral infection is probably s u p e r i m p o s e d on p r e e x i s t i n g AH-1.
HEPATITIS "C" PREVALENCE IN
VIRUS ANTIBODY PSORIASIS.
(ANTI-HCV)
B.Frider, S~ Sookoian, J.Panetta, M.Kina, F__~. V e y r e t o u , G__~. C a s t a ~ o a n d E. C h o u e l a . Internal Medicine-Hepatology, Serology and Dermatology Units. Argerich Hospital,Univ. of Buenos Aires. Argentina In s o m e p a t i e n t s with psoriasis {PS) the etiology of underlying liver disease is unknown. To i n v e s t i g a t e t h e p r e v a l e n c e o f a n t i - H C V and i t s clinical significance, 118 u n s e l e c t e d o u t p a t i e n t s with PS were studied prospectively. As c o n t r o l , the i.2% a n t i - H C V p r e v a l e n c e i n 60.000 d o n o r s was t a k e n . Nine o u t o f I18 samples (7.6%) p r o v e d p o s i t i v e by E l i s a I I w i t h a OD =/>3 by d o u b l e d e t e r m i n a t i o n (p < O.OOi). There were no d i f f e r e n c e s between a n t i - H C V + / as r e g a r d g e n d e r , a g e , h i s t o r y o f h e p a t i t i s and p r i o r treatment with methotrexate or etretinate. A n t i - H B c were (+) i n 17 {i5%) s a m p l e s . L i v e r b i o p s y i n a n t i - H C V ( + ) oases showed 4 Chronic active Hepatitis, 1 cirrhosis and i e s t h e a t o s i s . The high anti-HCV p r e v a l e n c e in this series is attributable t o i n f e c t i o n by i n n a p p a r e n t p a r e n t e r a I r o u t e s , as r e p o r t e d f o r HBV i n PS t h r o u g h m i n u t e s k i n a b r a s i o n s . In t h e p r e s e n c e o f l i v e r d i s e a s e i n PS p a t i e n t s , HCV i n f e c t i o n s h o u l d t h u s be c o n s i d e r e d as an alternative diagnosis.