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Therapeutic effect of silipide in patients with chronic hepatitis C non-responders (NRs) to interferon (IFN) treatment
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RISK FACTORS AT ANTI-HCV POSITIVE A/ID A~TI HIV I~SATIVE PATIENTS-PROSPECTIVE S T UDY L.BuligessU,D.Topal~,S.Consbanbinescu~S. Span~ohe~M~Volculescu Dep~/of'fn~.Med. and Hepa~ology,Fundeni Hospltal,Buchares~ Romania The authors studied ~ 2 patients wi~h an~i-HCV positive (Elisa II,~onolisa, Diagnostic Pasteur) and anti HIV negative (Westernblo~) serology.The following risk factors have been sisbema~Ically surched: blood and blood products ~ransfusions, slmred contaminated needles among drug users,accidental needle s~ick,high risk group-exposed professlonals,renal dialysis pablen~s,homosexuals. Among 353 patients (79,86%) one or more risk factors have been found:transfusions (n=72),exposed professionals (n= 5o),renal dialysis pablents (n=lSl),parenteral ~reatment (n=8o), 79 left patients can be considered as sporadic forms (17,87%). Our s~udy suggests Sha~ in Romania mesb of an~i HCV positive an~i HIV aegablve patients'are parenterally or percutaaeous Infected.
THE SIGNIFIOA/~CE OF A~TI HCV ANTIBODY IN A ROtaRIAN ~D~ATOLOGY DEPARTMENT L;Buli~escu2M.Stefan,D.Topal~,C.Posea, ~.Sandu Dope.of In~.Med.and Hepa~ol6~, Fundeni Hos~iUal,Bucharest,Romania The prevalence of an~ihepablbls C v i l ~ ~HGV) antibody (Monolisa second genera~ion ~es~) in 629 patientS hospitalized in our department in a ohroni~ liver disease (CLD) suspicion was 2~% (vs.~+o,2% in blood donors)~From 151 anti HCV posi~ tive pa~Icntsi7~88% were healthy carriers (group A),2q,16% with chronic actiVe hepatitis (group B) and'56,96% with liver cirrhosis (group C).We observed a signlficaa~ s~a~is~ical assoclabion of hepatitis B markers aud alcohol consumption in [~roup C and a bela~ed dlagnoois frequently in cirrho01c s~age.Hepa~ocellular carcinoma was dlagnosblca~ed in 6,62% cases.The study suggests the importan~ role played by HOV,being added ~o HBV and alcohol in CLD and CHC eUioIogy in Romania.
Papers read by title
SPORADIC ACUTE HEPATITIS E IN SPAIN M Buti, R Jardf, M Cotrina~ F Rodrf~uez-Frfas. R Esteban, J Guardia. Liver Unit, Hospital Universitari Vail d'Hebron, Barcelona, Spain. Isolated cases of acute sporadic hepatitis E have been recently reported in Europe and IgG anti-HEV were detected in European blood donors with a prevalence of 0.4% to 2.2%. AIM: To determine the prevalence of hepatitis E virus infection in acute sporadic hepatitis in Barcelona. PATIENTS AND METHODS: Serum samples from 90 patients with acute non A, non B, non C (NANBNC) hepatitis, 48 with acute B and D hepatitis and 224 with acute A hepatitis were studied. IgG anti-HEV were determined by EIA (Abbott Laboratories, Chicago, IL) and positive cases confirmed by an EIA using synthetic peptides. Confirmed positive were subsequently tested by lgM anti-VHE. RESULTS: IgG anti-HEV antibodies were detected in 9 (10~) of acute NANBNC hepatitis cases, in 3 (6.5%) of acute B and D hepatitis cases and in 10 (4%) of acute hepatitis A cases. The synthetic peptide-based EIA confirmed HEV infection in 5 of the 9 acute NANBNC hepatitis cases, in the 3 and 10 cases of acute B and D hepatitis and acute hepatitis A cases, respectively. IgM anti-HEV antibodies could be detected in only 2 of the 3 acute B and D hepatitis cases, being the rest negative. Analysis of serial serum samples demonstrated IgG anti-HEV seroconvertion in 3 of the ! 8 confirmed cases; one of them was also IgM positive. All anti-HEV confirmed cases were adults, had community-acquired hepatitis (no travels to HEV-endemic countries were recorded) and presented a self-limited disease, except one case who died of fitlminant hepatitis A with IgG antiHEV antibodies. CONCLUSIONS: These results demonstrate the existence of acute sporadic hepatitis E in a rather low prevalence in a non-endemic country.
THRRAPrOTICEFFECTOF SILIPIDIIN PATIENTSWIYE CHRONICHEPATITISC NOJ-HSPOD~'L~(NNs} TO INT~D']~ON(II~} TmTd]~T. G. Ruzzellit $. Moscarella, S. Narbsgli, C. Nareua, P. Sentilini. Ist. Clinics Hedica l], Universita" di Firenze, Firenze, Italy. The high frequency of no response to 1~ therapy in chronic hepatitis C induces to try alternative treatments. A silybin phosphatidylcholine complex (Sil), has been previously reported to be effective in chronic viral hepatitis. AIH: to assess the efficacy of $il in patients with chronic active hepatitis C (CMI) g~ to I!q therapy. DESIGR: Ten patients ( 8 N, 2 P, seas age: 59 yrs) with on significant variations of aspartate (AST)and asinotransferase (ALT) levels (l~s) to a previous treatment with recombinantI ~ alpha 2b (3 silllon units thrice weekly for 8 soothe) were studied according to a crossover, double blind, randonlzeddesign. After 6-12 months of IFN withdrawal, patients were assigned to: $i1 group (n:5) (360 ng/day, 2 sths)/washout (l nth) / Placebo (2sths); Placebo group (n=5)(Plac, 2 sths)/washout / Sil (identical doses and times). In each group, before and after Si] or Placebo, were detersined AST, ALT, alkaline phoshatase (AP}, y-glutasyltranspeptidane (rfYr) and bilirubin (Bil}. I~SULTS: in Sil group, seas (~ S~f) serum levels of A~ significantly decreased (-18ZI free 107 i 21 to 55 £ 18 U/L (p(O.02); ALTdecreased (-17Z) free 145 ~ 22 to 120 ~ 20 U/1 (p=O.061; no changes were observed in aeroi levels of AP (fro| 193 £ [6 to 214 ~ 15 U/I), yGT (from 64£ 12to7L~13U/l) andBil (from 1.0~0.2 t o 0 . 9 ~ 0 . 2 ng/dI). In placebo group, no changes were observed in AST (fees 79 ± 8 to 8 0 i i 4 ] , AGT (from 108L13 to 122~20}, AP (from 202L20 to 214 £15}, yGT(fron 58~[3 to 57~[2) andBil (froml.OLO.2to 0.81 L O.1) levels. CONCLUSION: Sil induced a reduction of transaainases in patients URnto IFN; this improvementdoes not seem to be related to the hypothetical antiviral and/or iuuncuodulant effect of Sil, but rather to its known stabilizing action on hepatocyte membranes.
RISK FACTORS AT ANTI-HCV POSITIVE A/ID A~TI HIV I~SATIVE PATIENTS-PROSPECTIVE S T UDY L.BuligessU,D.Topal~,S.Consbanbinescu~S. Span~ohe~M~Volculescu Dep~/of'fn~.Med. and Hepa~ology,Fundeni Hospltal,Buchares~ Romania The authors studied ~ 2 patients wi~h an~i-HCV positive (Elisa II,~onolisa, Diagnostic Pasteur) and anti HIV negative (Westernblo~) serology.The following risk factors have been sisbema~Ically surched: blood and blood products ~ransfusions, slmred contaminated needles among drug users,accidental needle s~ick,high risk group-exposed professlonals,renal dialysis pablen~s,homosexuals. Among 353 patients (79,86%) one or more risk factors have been found:transfusions (n=72),exposed professionals (n= 5o),renal dialysis pablents (n=lSl),parenteral ~reatment (n=8o), 79 left patients can be considered as sporadic forms (17,87%). Our s~udy suggests Sha~ in Romania mesb of an~i HCV positive an~i HIV aegablve patients'are parenterally or percutaaeous Infected.
THE SIGNIFIOA/~CE OF A~TI HCV ANTIBODY IN A ROtaRIAN ~D~ATOLOGY DEPARTMENT L;Buli~escu2M.Stefan,D.Topal~,C.Posea, ~.Sandu Dope.of In~.Med.and Hepa~ol6~, Fundeni Hos~iUal,Bucharest,Romania The prevalence of an~ihepablbls C v i l ~ ~HGV) antibody (Monolisa second genera~ion ~es~) in 629 patientS hospitalized in our department in a ohroni~ liver disease (CLD) suspicion was 2~% (vs.~+o,2% in blood donors)~From 151 anti HCV posi~ tive pa~Icntsi7~88% were healthy carriers (group A),2q,16% with chronic actiVe hepatitis (group B) and'56,96% with liver cirrhosis (group C).We observed a signlficaa~ s~a~is~ical assoclabion of hepatitis B markers aud alcohol consumption in [~roup C and a bela~ed dlagnoois frequently in cirrho01c s~age.Hepa~ocellular carcinoma was dlagnosblca~ed in 6,62% cases.The study suggests the importan~ role played by HOV,being added ~o HBV and alcohol in CLD and CHC eUioIogy in Romania.
Papers read by title
SPORADIC ACUTE HEPATITIS E IN SPAIN M Buti, R Jardf, M Cotrina~ F Rodrf~uez-Frfas. R Esteban, J Guardia. Liver Unit, Hospital Universitari Vail d'Hebron, Barcelona, Spain. Isolated cases of acute sporadic hepatitis E have been recently reported in Europe and IgG anti-HEV were detected in European blood donors with a prevalence of 0.4% to 2.2%. AIM: To determine the prevalence of hepatitis E virus infection in acute sporadic hepatitis in Barcelona. PATIENTS AND METHODS: Serum samples from 90 patients with acute non A, non B, non C (NANBNC) hepatitis, 48 with acute B and D hepatitis and 224 with acute A hepatitis were studied. IgG anti-HEV were determined by EIA (Abbott Laboratories, Chicago, IL) and positive cases confirmed by an EIA using synthetic peptides. Confirmed positive were subsequently tested by lgM anti-VHE. RESULTS: IgG anti-HEV antibodies were detected in 9 (10~) of acute NANBNC hepatitis cases, in 3 (6.5%) of acute B and D hepatitis cases and in 10 (4%) of acute hepatitis A cases. The synthetic peptide-based EIA confirmed HEV infection in 5 of the 9 acute NANBNC hepatitis cases, in the 3 and 10 cases of acute B and D hepatitis and acute hepatitis A cases, respectively. IgM anti-HEV antibodies could be detected in only 2 of the 3 acute B and D hepatitis cases, being the rest negative. Analysis of serial serum samples demonstrated IgG anti-HEV seroconvertion in 3 of the ! 8 confirmed cases; one of them was also IgM positive. All anti-HEV confirmed cases were adults, had community-acquired hepatitis (no travels to HEV-endemic countries were recorded) and presented a self-limited disease, except one case who died of fitlminant hepatitis A with IgG antiHEV antibodies. CONCLUSIONS: These results demonstrate the existence of acute sporadic hepatitis E in a rather low prevalence in a non-endemic country.
THRRAPrOTICEFFECTOF SILIPIDIIN PATIENTSWIYE CHRONICHEPATITISC NOJ-HSPOD~'L~(NNs} TO INT~D']~ON(II~} TmTd]~T. G. Ruzzellit $. Moscarella, S. Narbsgli, C. Nareua, P. Sentilini. Ist. Clinics Hedica l], Universita" di Firenze, Firenze, Italy. The high frequency of no response to 1~ therapy in chronic hepatitis C induces to try alternative treatments. A silybin phosphatidylcholine complex (Sil), has been previously reported to be effective in chronic viral hepatitis. AIH: to assess the efficacy of $il in patients with chronic active hepatitis C (CMI) g~ to I!q therapy. DESIGR: Ten patients ( 8 N, 2 P, seas age: 59 yrs) with on significant variations of aspartate (AST)and asinotransferase (ALT) levels (l~s) to a previous treatment with recombinantI ~ alpha 2b (3 silllon units thrice weekly for 8 soothe) were studied according to a crossover, double blind, randonlzeddesign. After 6-12 months of IFN withdrawal, patients were assigned to: $i1 group (n:5) (360 ng/day, 2 sths)/washout (l nth) / Placebo (2sths); Placebo group (n=5)(Plac, 2 sths)/washout / Sil (identical doses and times). In each group, before and after Si] or Placebo, were detersined AST, ALT, alkaline phoshatase (AP}, y-glutasyltranspeptidane (rfYr) and bilirubin (Bil}. I~SULTS: in Sil group, seas (~ S~f) serum levels of A~ significantly decreased (-18ZI free 107 i 21 to 55 £ 18 U/L (p(O.02); ALTdecreased (-17Z) free 145 ~ 22 to 120 ~ 20 U/1 (p=O.061; no changes were observed in aeroi levels of AP (fro| 193 £ [6 to 214 ~ 15 U/I), yGT (from 64£ 12to7L~13U/l) andBil (from 1.0~0.2 t o 0 . 9 ~ 0 . 2 ng/dI). In placebo group, no changes were observed in AST (fees 79 ± 8 to 8 0 i i 4 ] , AGT (from 108L13 to 122~20}, AP (from 202L20 to 214 £15}, yGT(fron 58~[3 to 57~[2) andBil (froml.OLO.2to 0.81 L O.1) levels. CONCLUSION: Sil induced a reduction of transaainases in patients URnto IFN; this improvementdoes not seem to be related to the hypothetical antiviral and/or iuuncuodulant effect of Sil, but rather to its known stabilizing action on hepatocyte membranes.