Natural history of extended lamivudine (LAM) treatment in patients with HBeAg negative chronic hepatitis B (CHB)

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Poster Sessions

dialysis and HCV Ab positivity. All the patients, except for one had accumulation of iron. Transaminase levels were CH in 5, IH in 9 and CN in 3 patients. HAI in the group with CH transaminase levels (10.4 4- 1.67) was significantly higher than IH (7.33 4- 1.87) and CN (5.67 4- 1.15) transaminase level groups (p < 0.05). The degree of fibrosis and hemosiderosis was significantly higher in the patients with CH transaminase levels than the other groups. Conclusion: In the CH transaminase group, the degree of periportal necrosis, fibrosis and hemosiderosis is significantly higher than IN and CN transaminase groups. Changes consistent with chronic hepatitis C is observed in all the patients who are HCV-RNA positive.

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NATURAL HISTORY OF EXTENDED LAMIVUDINE (LAM) TREATMENT IN PATIENTSWITH HBeAg NEGATIVE CHRONIC HEPATITIS B (CriB)

Nicholas Tassopoulos l, George Anagnostopoulos 2, Vana Sypsa 3, Johanna Delladetsima 4, Angelos Hantzakis 3. 1Department oflnternal

Medicine, Athens Metropolitan Hospital Athens; 2Department of Internal Medicine, Western Attica General Hospital Athens; 3Department of Hygiene and Epidemiology, Athens University Medical School Athens; 4Laboratory of Pathology, Laikon General Hospital Athens, Greece Introduction: Analysis of 3-year therapy with histological evaluation of CHB are reported here. Methods: 35 patients (29 M, 6 F) with a median age of 54 years were followed for 46 4- 17.5 (12-75) months. Complete response was defined as ALT normalization and serum HBVDNA negativity (HBVDNA < 2.5 pg/ml by bDNA). Breakthrough was defined as reappearance of HBVDNA. Results: At baseline liver histology showed mild in 7 (20%), moderate in 27 (77%) and severe CH in 1 (3%) pts. Cirrhosis was found in 15 (43%) pts. By Kaplan-Meier the cumulative probability of complete response to LAM progressively increased and reached 84.3% at 30 mo. Nineteen (54%) pts showed breakthrough. The cumulative probability of YMMD variant was 10.7% at 12-mo and 41.8% at 24-mo.; in 3 (16%) of the pts ALT normalized and HBVDNA became negative during LAM therapy. At month 24, liver tissue specimens in 31 pts showed improvement of necroinflammatory activity (NIA) score in 11 (73%) of 15 pts without and 7 (44%) of 16 pts with YMDD-variant. A third liver biopsy in 10 pts with YMDD, 8-26 months later showed improvement or unchanged NIA in 45% (5 of 11) pts. 5 (14%) pts developed complications of end stage liver disease 12-46 mo during LAM treatment. Conclusions: 1. The probability of complete response seems to be progressively increasing. 2. A 30-month treatment seems to be necessary for complete response. 3. Despite the appearance of YMDD in 54% of the pts they continue to derive benefit from LAM. 4. A 2-year at least treatment is necessary for histological improvement.

were measured at the start of the treatment in the patients of the observed group: total bilirubin 196.5 + 21; ALT 1646.6 + 181; AP 340.6 + 28; GGT 365.4 + 35 U/1. In the control group the values were respectively: 161.7 + 22; 1732.2 + 205; 350.3 + 25; 390.2 + 66. Significant decrease in the levels of bilirubin was observed in the patients treated with SAMe during the second week of therapy. After an 8-week treatment a significant decrease in the levels of the total bilirubin and GGT was noted in this patients compared to the patients in the control group (19.3 + 2 and 43.1 + 11; 71.7 + 11 and 179.3 + 30 U/l). In conclusion, an 8-week administration of SAMe is effective in improving clinical and biochemical measures of IHC and offers a new therapeutic modality for the symptomatic management of this syndrome in alcoholics with acute viral hepatitis.

~ - 3 ] PREVALENCE OF THE HEREDITARY HEMOCHROMATOSIS MUTATIONSAND THEIR PROGNOSTIC MEANING IN HCV PATIENTS: PILOT STUDY Carlos Terra ~, Jorge Stares ] , Henrique Coelho ] , Amanda Lobo 2, Bart Vanderborgh 2. ~Servico de Gastroenterologia do Hospital

Universitario Clementino Fraga Filho; 2Laboratorio de Biologia Molecular do Hospital Universitario Clementino Fraga Filho, Brazil Introduction: Patients with chronic HVC infection may develop cirrhosis and hepatocarcinoma. Early detection of a group of patients with propensity to a worst prognosis, by way of laboratory exam, could potentially offer them early treatment with phlebotomy. Objectives: To detect the presence of C282Y e H63D mutations in chronically HCV infected patients. Methods: PCR identified C282Y e H63D mutations in 228 patients. HCV infection was identified with HCV RNA. Chronic hepatitis C was diagnosed with liver biopsy. The diagnosis of hepatocellular carcinoma and cirrhosis were based on clinical, laboratory, liver biopsy and radiological criteria. Results: 228 patients were divided in three groups: chronic hepatitis (n = 113, Group I. Cirrhosis (n = 98, Group II). Hepatocellular carcinoma (n = 17, Group III). C282Y mutation was found in 10 heterozygous patients (4.38%). H63D mutation was found in 26.31% (24.12% heterozygous and 2.19% homozygous). Group I had one C282Y, H63D (heterozygous) and one H63D (homozygous) mutation, 3.5%, 22.12% and 1.77% respectively. The prevalence of these mutations in Group II was 6.12%, 25.51% and 3.06%. Group III had 0%, 29.41% and 0% mutations. Conclusion: There was no statistical significance between Group I and II for the presence of C282Y e H63D mutations (p = 0.5). There was no statistical difference between the studied groups (n = 228) and a control group (n = 82) regarding allelic and genotypic expressions. We concluded that the presence of the hereditary hemochromatosis mutations in HCV infected patients did not predict their progression to cirrhosis.

~ 2 - 7 EFFECTS OF S-ADENOSYL-L-METHIONINE (SAMe) THERAPY IN CHOLESTATICACUTE VIRAL HEPATITIS IN ALCOHOLICS

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Tatiana Tcherveniakova 1, Georgi Popov 2, Penka Ilieva 3. 1Chair of Infectious diseases, Medical University - Sofia, Sofia; 2Chair of Infectious diseases, Military Medical Academy, Sofia; 3Chair of Infectious diseases, Medical Institute - Pleven, Pleven, Bulgaria

M.E. Tomas 1, G. Castellano 1, J.M. Morales 2, A. Fuertes 3, M.S. Marcos I , J.D. Morillas l, J.A. Solis l . 1Gastroenterology Unit; 2Nephmlogy

The syndrome of intrahepatic cholestasis is a common complication of acute viral hepatitis in alcoholics. It may be severe or prolonged in which cases it causes therapeutic difficulties. The purpose of this study is to evaluate the efficiency of SAMe in alcoholics with acute viral hepatitis as far as the biochemical data for cholestasis and cytolysis are concerned. The study was performed in 86 alcoholic patients with cholestatic acute viral hepatitis A and B. 46 of them received an 8-week course of treatment with SAMe. The control group comprised 40 patients. Lessening and complete disappearance of the pruritus was observed by the fifth day of therapy in the treated with SAMe patients (p < 0.01). The following biochemical values

VIRAL LOAD AND HCV GENOTYPES IN RENAL TRANSPLANT RECIPIENTS

Department; 3Microbiology Department, Spain Introduction: It is not well known the impact of different HCV genotypes and the viral load in patients with long-term functioning renal transplant (RT). Aims: To determine the viral load and different HCV genotypes in a group of RT recipients. To compare patients with load viral < or >800,000 UI/mL. Methods: Fifty-four patients were screened. Two groups were described: group A: <800,000 UI/mL and group B: >800,000 UI/mL. Results (see table): Ultrasonography detected 8 patients with cirrhosis and portal hypertension. Follow-up ranged from 25 to 112 months (62 months). In seven cases the genotypes viral were lb. In two patients, the aminotrans-