Point Of Care Non-Invasive 13C Methacetin Breath Testing Accurately Identifies Significant Liver Inflammation and Fibrosis: A Novel Method For Assessing Liver Damage
G. Lalazar1; O. Pappo2; B. M
Background: Previous epidemiologic studies using the NHANES database have revealed a higher than expected prevalence of DM in patients infected with HCV. It has been hypothesized that insulin resistance may be the etiologic link although a precise cause and effect relationship remains unclear. This study's aim was to clarify the relationship between HCV and diabetes using the most recent iteration of the NHANES survey (2003-2004).
Methods: Demographic, physical exam, and laboratory data from the 2003-04 NHANES survey were combined into a single database using SPSS v.14.0. HCV status was determined using an ELISA, confirmed by RIBA. DM status was classified based on the subject's self-reported medical history. Cases coded as missing or indeterminate for either disorder were censored.
Results: The final database included 7,283 persons; 87 (1.2%) had HCV and 486 (6.7%) were diagnosed with DM. Mean age was 35.7
Rectal administration of low dose interferon alpha for patients with chronic hepatitis C led to elevation of platelet count and serum albumin level as well as suppression of viral replication.
Y. Haruna1; A. Inoue1
1. Dept. of Gastroenterology and Hepatology, Osaka Prefectural Medical Center, Osaka, Japan.
(Aim) It was suggested that rectally administered interferon (IFN) is transferred into the lymphatic system via rectal mucous membrane in animal study. We reported that administration of low dose IFN suppository could suppress hepatitis C virus (HCV) replication in patients with chronic hepatitis C. In this study, we focused on examining the long-term biological effects after the therapy. (Methods) Fourteen patients with chronic hepatitis C participated in the study. The IFN suppository, which was made in the Department of Pharmacy of Osaka Prefectural Medical Center, contained 1000 units of lymphoblastoid IFN alpha. The patients had administration of one IFN suppository daily for 24 weeks. Serum HCV viral loads, liver function and blood cell count were tested every 4 weeks during the treatment and until 72 weeks after the end of the treatment. The CD4/CD8 ratio and 2
easibility of induction by twice-daily administration of interferon-beta prior to the standard combination therapy using pegylated interferon-alpha-2b plus ribavirin
T. Nakatani 1; Y. Akashi1; H. Matsuo1; S. Takeyama1; M. Uejima1; Y. Yamane1; K. Hashimoto1; E. Kikuchi1
1. Gastroenterology, Nara Prefectural Nara Hospital, Nara, Nara, Japan.
Aims: It has been reported that longer treatment with combination therapy using pegylated interferon (IFN)-alpha-2b plus ribavirin (RIB) for patients infected with hepatitis C virus (HCV) leads to more effective viral eradication. However, in Japan where treatment period is limited, the achievement of early viral clearance should be necessary. We already confirmed the effectiveness of high dose IFN-alpha-2b induction in combination with RIB when the treatment period was limited to 24 weeks. In this study, it is evaluated whether IFN induction is also effective in the 48-week combination therapy using pegylated IFN-alpha-2b plus RIB.
Methods: Forty patients chronically infected with genotype 1b HCV were divided into 2 groups. Thirty-two patients underwent standard 48-week combination therapy using 1.5
Retrospective Analysis of the Effect of Taking a Statin Along with Peginterferon and Ribavirin (PI+R) on SVR.
T. Bader1; M. Madhoun1; S. Rizvi1
1. VA Medical Center, University of Oklahoma, Oklahoma City, OK, USA.
Methods: 104 patients taking PI+R were compared to 30 patients who by chance took triple therapy [(PI+R) plus a statin]. A modified intent to treat approach was taken whereby if any patient had a least one data point after starting therapy, he or she was included in the denominator.
Virtually all patients taking a statin were on simvastatin (n=25); 2 were on lovastatin, 2 on atorvastatin and 1 on fluvastatin.
The pooled SVR rate* for the 104 patients on standard treatment was 37%. This is the highest SVR ever reported in the medical literature for a VA based population.
The pooled SVR rate for the triple therapy group was 63%. In terms of HCV subgroups, the effect was statistically strongest for genotype one, the most difficult subgroup to treat.
Conclusion: Statins appear to be associated with a higher SVR rate of standard PI+R therapy. This observation principally occurs on the basis of a medium powered statin (simvastatin) in terms of the Ikeda experiment (Hepatology 2006;44:117-125). The only patient to take fluvastatin during the study was cured. Statins need to be studied prospectively for their effect on hepatitis C and the outcome of treatment.
(%) p value
Genotype 1 16/65 (25) .014 11/20
(77) .43 3/5
(47) .035 5/5
Analysis* 37% .009 63%
*Pooled analysis makes the population proportion 70% genotype 1 and 30% non-genotype 1 in order to mimic the proportion of genotypes in the USA. This is the standard method of reporting SVRs.
Some discussion already here: http://www.medhelp.org/forums/hepatitis/messages/46494.html
Increased SVR Rate with 48 Wks