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Chronic hepatitis C virus infection and neurological and psychiatric disorders:An overview

World Journal of Gastroenterology 2015年第8期21卷 2269-2280页

作者： luigi elio a.inolfi Riccardo Nevola Giacomo Lus Luciano Restivo Barbara Guerrera Ciro Romano Rosa Zampino Luca Rinaldi Ausilia Sellitto Mauro Giordano Aldo Marrone Clinical Hospital of Marcianise Second University of Naples Department of Medical Surgical Neurological Geriatric and Metabolic Sciences Second University of Naples Neurological Sciences Second University of Naples

Hepatitis C virus(HCV)infection is considered a systemic disease because of involvement of other organs and tissues concomitantly with liver *** the extrahepatic manifestations,neuropsychiatric disorders have been reported in up to 50%of chronic HCV infected *** the central and peripheral nervous system may be involved with a wide variety of clinical *** HCV-associated neurological conditions include cerebrovascular events,encephalopathy,myelitis,encephalomyelitis,and cognitive impairment,whereas"brain fog",depression,anxiety,and fatigue are at the top of the list of psychiatric ***,HCV infection is known to cause both motor and sensory peripheral neuropathy in the context of mixed cryoglobulinemia,and has also been recently recognized as an independent risk factor for *** extrahepatic manifestations are independent of severity of the underlying chronic liver disease and hepatic *** brain is a suitable site for HCV replication,where the virus may directly exert neurotoxicity;other mechanisms proposed to explain the pathogenesis of neuropsychiatric disorders in chronic HCV infection include derangement of metabolic pathways of infected cells,alterations in neurotransmitter circuits,autoimmune disorders,and cerebral or systemic inflammation.A pathogenic role for HCV is also suggested by improvement of neurological and psychiatric symptoms in patients achieving a sustained virologic response following interferon treatment;however,further ad hoc trials are needed to fully assess the impact of HCV infection and specific antiviral treatments on associated neuropsychiatric disorders.

关键词： Hepatitis C virus Neurological disorders Psychiatr

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Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression

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World Journal of Hepatology 2014年第9期6卷 677-684页

作者： Rosa Zampino Adriana Boemio Aldo Marrone Luciano Restivo Maria Chiara Fascione Riccardo Nevola luigi elio a.inolfi Nicola Coppola Carmine Minichini Mario Starace Evangelista Sagnelli Grazia Cirillo Emanuele Miraglia del Giudice Maria Stanzione Emanuele Durante-Mangoni Giovanna Salzillo Department of Medical SurgicalNeurologicalMetabolicand GeriatricSciencesSecond University of Naples80100 NaplesItaly Clinical Hospital of Marcianise ASL Caserta81025 Marcianise (CE)Italy Department of Medical SurgicalNeurologicalMeta-bolicand GeriatricSciencesSecond University of Naples80100 NaplesItaly Department of Mental Health and Public Medicine Section of Infectious DiseasesSecond University of Naples80100 NaplesItaly Department of Pediatrics Second University of Naples80100 NaplesItaly Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A. Lanzara"Second University of Naples80100 NaplesItaly Internal Medicine Monaldi Hospital Second University of 80100 NaplesItaly

AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected ***:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV *** of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were ***:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with *** HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV *** HBV-HCV group,liver fibrosis was not associated with steatosis,IR or *** infection was the independent predictor of advanced liver ***:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.

关键词： Steatosis Insulin resistance Hepatitis B and C viruses co-infection Patatin-like phospholipase domain-containing 3 Liver fibrosis

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Boceprevir or telaprevir in hepatitis C virus chronic infection:The Italian real life experience

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World Journal of Hepatology 2016年第22期8卷 949-956页

作者： Antonio Ascione luigi elio a.inolfi Pietro Amoroso Angelo Andriulli Orlando Armignacco Tiziana Ascione Sergio Babudieri Giorgio Barbarini Michele Brogna Francesco Cesario Vincenzo Citro Ernesto Claar Raffaele Cozzolongo Giuseppe D’Adamo Emilio D’Amico Pellegrino Dattolo Massimo De Luca Vincenzo De Maria Massimo De Siena Giuseppe De Vita Antonio Di Giacomo Rosanna De Marco Giorgio De Stefano Giulio De Stefano Sebastiano Di Salvo Raffaele Di Sarno Nunzia Farella Laura Felicioni Basilio Fimiani Luca Fontanella Giuseppe Foti Caterina Furlan Francesca Giancotti Giancarlo Giolitto Tiziana Gravina Barbara Guerrera Roberto Gulminetti Angelo Iacobellis Michele Imparato Angelo Iodice Vincenzo Iovinella Antonio Izzi Alfonso Liberti Pietro Leo Gennaro Lettieri Ileana Luppino Aldo Marrone Ettore Mazzoni Vincenzo Messina Roberto Monarca Vincenzo Narciso Lorenzo Nosotti Adriano Maria Pellicelli Alessandro Perrella Guido Piai Antonio Picardi Paola Pierri Grazia Pietromatera Francesco Resta Luca Rinaldi Mario Romano Angelo Rossini Maurizio Russello Grazia Russo Rodolfo Sacco Vincenzo Sangiovanni Antonio Schiano Antonio Sciambra Gaetano Scifo Filomena Simeone Annarita Sullo Pierluigi Tarquini Paolo Tundo Alfredo Vallone Depart-ment of Medicine Center for Liver Diseases "Buon Consiglio" -Fatebenefratelli Hospital Internal Medicine Unit Second University of Naples VI Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Division of Gastro- enterology Casa Sollievo Sofferenza Hospital IRCCS Division of Infectious Diseases Belcolle Hospital IX Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Clinical of Infectious Disease University of Sassari Infectious Disease IRCCS San Matteo Division of Infectious Diseases and Liver Unit "G. Iazzolino" Hospital Division of Infectious Diseases "Annunziata" Hospital Depart-ment of Internal Medicine Umberto I Hospital Internal Medicine Ospedale Evangelico Villa Betania Division of Gastroenterology IRCCS "S.de Bellis" Hospital Internal Medicine Unit Pescara-Penne Hospital Gastroenterology Unit Marcianise Hospital Liver Unit AORN Cardarelli Liver Unit Policlinico "Mater Domini" Service of Medical Day Hospital "Rummo" Hospital Internal Medicine Regina Margherita Hospital Division of Gastroenterology "Annunziata" Hospital Infectious Disease Matera Hospital First Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Division of Infectious Diseases AO Melacrino- Bianchi-Morelli Infectious and Tropical Disease Policlinico Umberto I Division of Infectious Disease Maria SS Addolorata Hospital Division of Infectious Diseases S. Anna and S. Sebastiano Hospital Outpatients Service for Liver Diseases "Loreto Crispi" Hospital V Division of Infectious Diseases Cotugno Hospital AORN "Ospedali dei Colli" Department of Medical Surgical Neurological Geriatric and Metabolic Sciences Second Univer-sity of Naples Liver Unit Policlinico Casilino Medicine and Health Unit for Prisoners Belcolle Hospital Internal Medicine Unit "Ascalesi" Hospital Gastrointestinal and Liver Department National Institute for Health Migration and Poverty Liver Unit Azienda Ospedaliera San Camillo Forlanini VII Division of Infectious Diseases

AIM: To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus(HCV) genotype 1 in the real-world settings. METHODS: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-Taq Man2.0(Roche, LLQ 25 IU/m L). RESULTS: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57(range 18-78), of whom 18.3% were over 65; mean body mass index 25.6(range 16-39); genotype 1b(79.4%); diagnosis of cirrhosis(38.2%); and fibrosis F3/4(71.2%). The following drugs were used: Telaprevir(66.2%) and PEG-IFN-alpha2a(67.6%). Patients were na?ve(24.4%), relapsers(30.5%), partial responders(14.8%) and null responders(30.3%). Overall, adverse events(AEs) occurred in 617 patients(73.9%) during the treatment. Anemia was the most frequent AE(52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure(15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age. CONCLUSION: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, nonresponders to peginterferon + ribavirin.

关键词： Boceprevir Telaprevir Chronic hepatitis Antiviral therapy Peg-interferon Ribavirin

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