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Gastric autoimmune disorders in patients with chronic hepatitis C before,during and after interferon-alpha therapy

World Journal of Gastroenterology 2003年第7期9卷 1487-1490页

作者： Carlo Fabbri M.Francesca Jaboli silvia giovanelli Francesco Azzaroli Alessandro Pezzoli Esterita Accogli Stefania Liva Giovanni Nigro Anna Miracolo Davide Festi Antonio Colecchia Marco Montagnani Enrico Roda Giuseppe Mazzella Department of Internal Medicine and Gastroenterology University of BolognaBolognaItaly Department of Medicine and Aging University"G D'Annunzio"ChietiItaly

AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-interferon (IFN) treatment on autoimmune gastritis. METHODS:We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN *** evaluated:a) the baseline prevalence of autoimmune gastritis,b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3,6 and 12 months),c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA),gastrin,anti-thyroid,and anti-non-organ- specific antibodies. RESULTS:APCA positivity and 3-fold gastrin levels were detected in 3 (1.6%) and 9 (5%) patients,respectively,at baseline,in 25 (13%) and 31 (16%) patients at the end of treatment (both P<0.001,vs baseline),and in 7 (4%) and 14 (7%) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively,vs baseline;P=not significant vs end of treatment).The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P=0.0001),no relationship was found with other markers of autoimmunity. CONCLUSION:In HCV patients,IFN frequently precipitates latent autoimmune gastritis,particularly in *** our 12-month protocol,the phenomenon generally *** APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.

关键词： Adult Aged Antiviral Agents dosage Autoimmune Diseases Female Gastrins Gastritis Helicobacter Infections Helicobacter pylori Hepatitis C, Chronic Humans Interferon-alpha Male Middle Aged Organ Specificity Parietal Cells, Gastric Prevalence Prospective Studies Thyroid Gland Treatment Outcome

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Interferon plus ribavirin and interferon alone in preventing hepatocellular carcinoma: A prospective study on patients with HCV related cirrhosis

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World Journal of Gastroenterology 2004年第21期10卷 3099-3102页

作者： Francesco Azzaroli Esterita Accogli Giovanni Nigro Davide Trerè silvia giovanelli Anna Miracolo Francesca Lodato Marco Montagnani Mariarosa Tamé Antonio Cloecchia Constance Mwangemi Davide Festi Enrico Roda Massimo Derenzini Giuseppe Mazzella Department of Internal Medicine and Gastroenterology University of Bologna Department of Experimental Pathology University of Bologna

AIM:To determine the role of interferon(IFN)with or withoutribavirin in preventing or delaying hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV)related *** on the preventive effect of IFN plusribavirin treatment are ***:A total of 101 patients(62 males and 39 females,mean age 55.1±1.4 years)with histologically proven HCVrelated liver cirrhosis plus compatible biochemistry andultrasonography were enrolled in the *** ultrasonography were performed every 6 *** liver biopsy was performed on all detected ***-up lasted for 5 *** proliferation,evaluated by measuring Ag-NOR proteins in hepatocytesnuclei,was expressed as AgNOR-Proliferative index(AgNOR-PI)(cut-off=2.5).Forty-one patients(27 males,14 females)were only followed up after the end of anyearly treatment with IFN-alpha2b(old treatment controlgroup=OTCG).Sixty naive patients were stratified accordingto sex and AgNOR-PI and then randomized in two groups:30 were treated with IFN-alpha2b+ribavirin(treatmentgroup=TG),the remaining were not treated(control group=CG).Nonresponders(NR)or relapsers in the TG receivedfurther IFN/ribavirin treatments after a 6 mo of ***:AgNOR-PI was significantly lowered by IFN(P2.5(26% vs3%,P<0.01).Two NR in the OTCG,none in the TG and 9 patients in the CG developed HCCduring *** Kaplan-Mayer survival curves showedstatistically significant differences both between OTCG andCG(P<0.004)and between TG and CG(P<0.003).CONCLUSION:IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best resultsin terms of HCC ***-PI is a useful markerof possible HCC development.

关键词： Antineoplastic Agents dosage Antiviral Agents Carcinoma, Hepatocellular control Drug Therapy, Combination Female Hepatitis C, Chronic Humans Interferons Liver Cirrhosis Liver Neoplasms Male Middle Aged Nucleolus Organizer Region Prospective Studies Ribavirin Silver Staining

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Long-term alpha interferon and lamivudine combination therapy in non-responder patients with anti-HBe-positive chronic hepatitis B:Results of an open,controlled trial

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World Journal of Gastroenterology 2003年第7期9卷 1491-1495页

作者： M. Francesca Jaboli Carlo Fabbri Stefania Liva Francesco Azzaroli Giovanni Nigro silvia giovanelli Francesco Ferrara Anna Miracolo Sabrina Marchetto Marco Montagnani Antonio Colecchia Davide Festi Letizia Bacchi Reggiani Enrico Roda Giuseppe Mazzella Department of Internal Medicine and Gastroenterology University of BolognaItaly Department of Gastroenterology and Gastrointestinal Endoscopy Bellaria HospitalBolognaItaly Department of Medicine and Aging University of ChietiItaly Department of Cardiology University of BolognaItaly

AIM: To investigate the safety and efficacy of long-term combination therapy with alpha interferon and lamivudine in non-responsive patients with anti-HBe-positive chronic hepatitis ***: 34 patients received combination treatment (1 month lamivudine, 12 month lamivudine+interferon, 6month lamivudine), 24 received lamivudine (12 months),24 received interferon (12 months). Interferon was administered at 6 MU tiw and lamivudine at 100 mg orally once daily. Patients were followed up for 6 months after ***: At the end of treatment, HBV DNA negativity rates were 88 % with lamivudine+interferon, 99 % with lamivudine and 55 % with interferon, (P=0.004, combination therapy vs. interferon, and P=0.001 lamivudine ***), and serum transaminase normalization rates were 84 %, 91% and 53 % (P=0.01 combination therapy vs. interferon, and P=0.012 lamivudine vs. interferon). Six months later, HBV DNA negativity rates were 44 % with lamivudine+interferon, 33 % with lamivudine and 25 % with interferon, and serum transaminase normalization rates were 61%, 42 % and 45 %, respectively, without statistical significance. No YMDD variants were observed with lamivudine+interferon (vs. 12 % with lamivudine). The combination therapy appeared to be safe. CONCLUSION: Although viral clearance and transaminase normalization are slower with long-term lamivudine+interferon than that with lamivudine alone, the combination regimen seems to provide more lasting benefits and to protect against the appearance of YMDD variants. Studies with other regimens regarding sequence and duration are needed.

关键词： Adult Antiviral Agents dosage Drug Therapy, Combination Female Hepatitis B, Chronic Humans Interferon-alpha Lamivudine Male Middle Aged Reverse Transcriptase Inhibitors Treatment Outcome

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