The effect of antiviral therapy on clinical outcome of HCV cirrhosis with portal hypertension: a prospective cohort study.

Management of hepatitis B virus infection in the underprivileged world.

The impact of sustained virological response on clinical outcomes in compensated HCV cirrhosis: a prospective cohort study

Treating chronic hepatitis C in daily practice with PEG-IFN alfa2B and ribavirin. An Italian multicentre study

Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study

The effect of achieving a sustained virological response (SVR) following interferon-α (IFNα) treatment on the clinical outcomes of patients with HCV-related cirrhosis is unknown. In an attempt to assess the risk of liver-related complications, HCC and liver-related mortality in patients with cirrhosis according to the response to IFNα treatment, a retrospective database was developed including all consecutive patients with HCV-related, histologically proven cirrhosis treated with IFNα monotherapy between January 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24 weeks after IFNα discontinuation. HCC was assessed by ultrasound every 6 months. Independent predictors of al…

HCV Prevalence in Italy an Epidemiological, Observational, Cross-Sectional, Multicenter Study Participating Centers.

There is a lack of updated nationwide records regarding hepatitis C virus (HCV) infection among drug addicts in Italy. The prevalence and characteristics of HCV infection in a national sample of drug addicts in Italy were determined. Five hundred forty-three drug addicts (mean age 35.3 years, 85.1% males), selected from 25 Italian Centers for Substance Dependence were enrolled to be evaluated for anti-HCV, HCV-RNA, HCV genotype, HBV markers, anti-HDV, and anti-HIV during the period of April-November 2009. Anti-HCV prevalence was 63.9%. HCV-RNA was detected in 68.3% of patients positive for anti-HCV. Genotypes 1 and 3 prevailed (49.3% and 39.7%, respectively). However, 9.3% of the subjects h…

Kinetic analysis of insulin resistance and serum adipocytokines levels during peginterferon alpha-2A plus ribavirin therapy in non-diabetic HCV patients

Epidemiology and clinical course of drug-induced liver injury

Lack of correlation between serum anti-HBcore detectability and hepatocellular carcinoma in patients with HCV-related cirrhosis.

Noninvasive assessment of liver fibrosis in thalassaemia major patients by transient elastography (TE) - lack of interference by iron deposition.

The correlation between liver stiffness, measured by transient elastography, liver fibrosis, using the histological METAVIR score, and iron overload, measured by atomic absorption spectrometry was evaluated in 56 homozygous-b-thalassaemics. Liver stiffness increased proportionally to liver fibrosis staging (r = 0Æ70; P > 0Æ001) independently of liver iron concentration (r = 0Æ01; P = 0Æ932). The area under the receiver-operating characteristic curve for prediction of cirrhosis was 0Æ997 (95% confidence interval [CI]: 0Æ925–1Æ000) with cut-off of 13 kPa with 100% sensitivity (95% CI: 69Æ0–100Æ0) and 95% specificity (95% CI: 84Æ2–99Æ3). Transient elastography is a reliable non-invasive tool f…

STORIA NATURALE DELLA CIRROSI EPATICA

Characteristics of liver cirrhosis in Italy: results from a multicenter national study.

Abstract Background. In 1992, the characteristics of liver cirrhosis in Italy were assessed in a cross-sectional study among 1829 cirrhosis patients attending 21 tertiary centres. Aim. To evaluate the characteristics of cirrhosis patients 9 years later. Patients. A total of 2185 consecutive cirrhosis patients were enrolled over a 6-month period in 79 hospitals located throughout Italy, randomly selected by means of systematic cluster sampling. Results. The main agent associated with cirrhosis was hepatitis C virus, which was found in 69.9% of the patients and was the only etiologic factor in 51.1% of the patients. Hepatitis B surface antigen was present in the serum of 13.0% of the cases (i…

PEG-INTERFERON PLUS RIBAVIRIN IN COMPENSATED HCV CIRRHOSIS WITH PORTAL HYPERTENSION: THE ROLE OF RAPID AND EARLY VIROLOGICAL RESPONSE IN PREDICTING THE SUSTAINED VIROLOGICAL RESPONSE

Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study.

The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross-sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period…

HCV infection is a risk factor for gallstone disease in liver cirrhosis: an Italian epidemiological survey.

HALT-C in the final analysis: A molehill out of a mountain

Prolonged therapy of advanced chronic hepatitis C with low-dose peginterferon. Di Bisceglie AM, Shiffman ML, Everson GT, Lindsay KL, Everhart JE, Wright EC, Lee WM, Lok AS, Bonkovsky HL, Morgan TR, Ghany MG, Morishima C, Snow KK, Dienstag JL, HALT-C Trial Investigators. Background In patients with chronic hepatitis C who do not have a response to antiviral treatment, the disease may progress to cirrhosis, liver failure, hepatocellular carcinoma, and death. Whether long-term antiviral therapy can prevent progressive liver disease in such patients remains uncertain. Methods We conducted a randomized, controlled trial of peginterferon alfa-2a at a dosage of 90μg per week for 3.5 years, as comp…

HCV genotypes in western Sicily: any evidence for a shift?

Background: The relative prevalence of each HCV strain in a specific country is characterized by a predominant genotype and a number of other sub-prevalent types. Over the last decade a shift away from the prevalent HCV G1 towards G3 and G4 has been reported in some countries, and might affect the global management of HCV disease. Aim: In order to assess any possible variation in the prevalence of HCV genotypes in Sicily, we surveyed an hospital based cohort of subjects with chronic HCV infection observed over the last ten years. Patient and methods: 3209 Italian patients resident in Western Sicily, 1842/1367 M/F, between 1 and 89 years of age, presented at our tertiary referral Laboratory …

PEG_interferon plus Ribavirin in compensated HCV cirrhosis with portal hypertension: the role of rapid and early virological response in predicting the sustained virological response

In vivo liver expression of TLR2, TLR3 and TLR7 in chronic hepatitis C

The role of innate immune response mediated by Toll-like receptors in HCV infection, is not yet well understood and there is a lack of data regarding liver tissue expression of these molecules in chronic hepatitis C (CHC). Our study is aimed to investigate ex vivo, liver expression of TLR2, TLR3 and TLR7, which are more involved in the immune-pathogenesis of CHC, and to explore possible correlations with features of disease. We obtained liver biopsies and collected peripheral blood mononuclear cells (PBMC) from 23 consecutive patients with CHC and from 6 patients of control, without liver disease, undergoing surgery for cholecystectomy. The levels of TLRs mRNA in the samples were determined…

DISTRIBUTION OF ESOPHAGEAL DYSMOTILITIES AMONG PATIENTS WITH NON-CARDIAC CHEST PAIN, DYSPHAGIA OR BOTH

disphagia, non-cardiac chest pain

The impact of sustained virological response on clinical outcome in compensated HCV cirrhosis: a prospective cohort study

The optimal dose of ribavirin for chronic hepatitis C: From literature evidence to clinical practice: The optimal dose of ribavirin for chronic hepatitis C.

Approximately 170 million people worldwide are chronically infected by hepatitis C virus (HCV), which can result in progressive hepatic injury and fibrosis, culminating in cirrhosis and end-stage liver disease. The benchmark therapy for untreated HCV patients is a combination of pegylated interferon-alpha (PEG-IFN) and ribavirin (RBV). Several studies have suggested several potential new approaches to improve HCV therapy-optimization of the dose and duration of RBV therapy, accompanied by careful clinical management, is crucial in ensuring the greatest likelihood of a long response to therapy. RBV causes serious side effects, but in clinical practice, there are no alternatives for the treat…

New therapeutic prospects in HCV treatment.

Influence of liver disease staging on sustained virological response in HCV “Favourable” genotypes treated with PEG-interferon and ribavirin: Data from clinical practice

STAGING OF FIBROSIS BY LIVER STIFFNESS MEASUREMENT IN THALASSEMICS WITH IRON OVERLOAD

The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C.

Aims To assess whether host metabolic factors influence the degree of hepatic steatosis and fibrosis in patients infected with hepatitis C virus, and to evaluate the impact of anti-viral therapy on insulin resistance and serum levels of adipocytokines. Methods Clinical and biochemical features, anthropometrical characteristics, and levels of fasting insulin, leptin, adiponectin and resistin were measured in ‘naı¨ve’ patients with chronic hepatitis C, before, during and after therapy with Peg-Interferon-alpha 2a plus Ribavirin. Results Forty-eightpatientswereincluded(M/F28/20;meanage50.0 12.6years; 62.5% genotype-1). Body mass index was 26.4 4.0 kg/m2 , and visceral obesity was present in 24…

Esophageal motility changes after thyroidectomy: possible associations with postoperative voice and swallowing disorders

Meccanismi immunologici e molecolari del danno epatico da farmaci

I polimorfismi genetici e/o i fattori ambientali, ad esempio l’alcol e/o i farmaci concomitanti, contribuiscono alla suscettibilità individuale nel determinare il danno epatico da farmaci. L’HLA si è dimostrato essere uno dei più importanti predittore di suscettibilità individuale anche per quei farmaci per i quali questa non era stata mai sospettata.

The aetiological pattern of hepatocellular carcinoma ( HCC) in Italy is changing

The aetiological pattern of hepatocellular carcinoma ( HCC) in Italy is changing.

High rate of spontaneous viral clearance in patients with iatrogenic acute hepatitis C

Tumor Necrosis Factor Alpha Antagonists and Occurrence of Autoantibodies in Inflammatory Bowel Disease Patients: A Single Center Experience

Background & Aims: Appearance of auto antibodies have been described during anti-tumor necrosis factor (TNF) alpha therapy; however, their prevalence and clinical relevance are still unclear. We investigated prevalence of autoantibodies in inflammatory bowel diseases (IBD) patients on anti-TNFα treatment and occurrence of clinical symptoms. Methods: Titers of ANA, anti-dsDNA, SMA, AMA, LKM were evaluated from blood samples in patients receiving anti-TNFα inhibitor (adalimumab, infliximab). Results: Among 39 patients treated with anti-TNFα therapy, twenty of them developed ANA, mostly induced by infliximab. 55% ANA positive patients developed peripheral polyarthralgias with no need for inter…