AIM:To determine whether acoustic radiation force impulse(ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus(HCV) hepatitis.METHODS:We performed a multi...AIM:To determine whether acoustic radiation force impulse(ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus(HCV) hepatitis.METHODS:We performed a multicenter study including 274 subjects with HCV chronic hepatitis in which we compared ARFI with liver biopsy(LB).In each patient we performed LB(evaluated according to the Metavir score) and ARFI measurements(using a Siemens Acuson S2000TM ultrasound system:10 valid measurements were performed and median values were calculated and expressed in meters/second(m/s).RESULTS:A direct,strong,correlation(Spearman r = 0.707) was found between ARFI measurements and fibrosis(P < 0.0001).For predicting the presence of fibrosis(F ≥ 1 Metavir),significant fibrosis(F ≥ 2),severe fibrosis(F ≥ 3) and cirrhosis(F = 4),the cutoff values of 1.19,1.21,1.58 and 1.82 m/s were determined,respectively,liver stiffness measurements had 73%,84%,84% and 91% Se respectively;93%,91%,94%,90% Sp,respectively;with AUROCs of 0.880,0.893,0.908 and 0.937,respectively.CONCLUSION:ARFI measurement is a reliable method for predicting the severity of fibrosis in HCV展开更多
AIM: To assess whether a correlation exists between oxidative DNA damage occurring in chronic HCV-related hepatitis and expression levels of pro-inflammatory cytokines, TGF-αand c-myc. METHODS: The series included 37...AIM: To assess whether a correlation exists between oxidative DNA damage occurring in chronic HCV-related hepatitis and expression levels of pro-inflammatory cytokines, TGF-αand c-myc. METHODS: The series included 37 patients with chronic active HCV-related hepatitis and 11 with HCV-related compensated cirrhosis. Eight-hydroxydeoxyguanosine in liver biopsies was quantified using an electrochemical detector. The mRNA expression of TIMF-α, IL-1β, TGF-αand c-myc in liver specimens was detected by semi-quantitative comparative RT-PCR. RESULTS: TNF-αlevels were significantly higher in hepatitis patients than in cirrhosis patients (P=0.05). IL-1βwas higher in cirrhosis patients (P=0.05). A significant correlation was found between TNF-αand staging (P=0.05) and between IL-1βlevels and grading (P=0.04). c-myc showed a significantly higher expression in cirrhosis patients (P=0.001). Eight-hydroxydeoxyguanosine levels were significantly higher in cirrhosis patients (P=0.05) and in HCV genotype 1 (P=0.03). Considering all patients, 8-hydroxydeoxyguanosine levels were found to be correlated with genotype (P=0.04) and grading (P=0.007). Also multiple logistic regression analysis demonstrated a significant correlation among the number of DNA adducts, TNF-αexpression and HCV genotype (P=0.02). CONCLUSION: In chronic HCV-related liver damage, oxidative DNA damage correlates with HCV genotype, grading and TNF-αlevels. As HCV-related liver damage progresses, TNF-αlevels drop while IL-1βand c-myc levels increase, which may be relevant to liver carcinogenesis.展开更多
The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chr...The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 pa-tients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.展开更多
BACKGROUND: The resolution of hepatitis C, evidenced by normalization of liver function and disappearance of hepatitis C virus RNA from serum as determined by conventional laboratory assays, reflects virus eradication...BACKGROUND: The resolution of hepatitis C, evidenced by normalization of liver function and disappearance of hepatitis C virus RNA from serum as determined by conventional laboratory assays, reflects virus eradication. But in interferon treated patients the HCV RNA in serum sometimes could not show the virus in cells. Such factors as virus genotype, HCV RNA contents in serum, HCV specific cellular immunities after treatment were reported to predict the response to interferon therapy. In most patients, HCV RNA could detect the virus in peripheral blood mononucle-ar cell. The aim of this study was to investigate the predictive value of HCV RNA in PBMC of patients with chronic hepatitis C after interferon treatment. METHODS: Sixteen patients with chronic hepatitis C were treated with interferon for 24 weeks, and they all get complete responses at 12 weeks of treatment. At the end of treatment, the HCV RNA in PBMC and serum were detected by RT-PCR, and after stopping treatment, HCV RNA in serum was monitored continually. RESULTS: In 9 patients who were HCV RNA positive in their PBMC at the end of treatment, 8 showed serum HCV RNA positive after 24 weeks and another 1 after 1 year. In 7 patients with negative HCV RNA in their PBMC, only 2 patients relapsed in serum HCV RNA after 1-year follow-up, and others remained viral response after 3.5 years. CONCLUSION: HCV RNA in PBMC at the end of IFN treatment is a predictor of durable response to antiviral therapy in patients with chronic hepatitis C.展开更多
Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death...Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals(DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa(Peg-IFN) + ribavirin(RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.展开更多
Objective This study was undertaken to investigate the influencing factors on serum ALT level and hepatitis C virus(HCV)RNA titer in chronic hepatitis C(CHC)patients.Methods All patients enrolled into this study were ...Objective This study was undertaken to investigate the influencing factors on serum ALT level and hepatitis C virus(HCV)RNA titer in chronic hepatitis C(CHC)patients.Methods All patients enrolled into this study were anti-HCV positive.Retrospective tracing method was applied to detect serum ALT level and HCV RNA titer and to collect general information of the patients such as genders,age groups,interferon medication history,infection pathways,height and weight.Then the multi-factor analysis was adopted with the application of binominal logistic regression mode.Results The abnormal rate of ALT level was positively correlated to HCV RNA and gender while negatively correlated to interferon medication history and age group,with Wald value of the 4 factors as 39.604,11.823,18.991 and 7.389,respectively.The positive rate of HCV RNA was negatively correlated to interferon medication history and gender while positively correlated to ALT level,with corresponding Wald value of the 3 factors as81.394,7.618 and 27.562,respectively.Conclusions The normal ALT level in HCV infected patients was associated with viral load,age,gender and interferon medication history,while the normal rate of HCV RNA titer was closely associated with gender,interferon medication history and ALT level.展开更多
目的探讨慢性HCV感染者感染慢性化产生与白细胞介素(IL)家族细胞因子含量变化的关系。方法收集慢性HCV感染者及健康人群的血液标本各40人份,ELISA法检测血液中IL-2、IL-4、IL-5、IL-6、IL-12、IL-18细胞因子含量变化。结果 HCV感染者和...目的探讨慢性HCV感染者感染慢性化产生与白细胞介素(IL)家族细胞因子含量变化的关系。方法收集慢性HCV感染者及健康人群的血液标本各40人份,ELISA法检测血液中IL-2、IL-4、IL-5、IL-6、IL-12、IL-18细胞因子含量变化。结果 HCV感染者和健康人群的IL-2、IL-5、IL-18(pg/m L)分别为:0.28±0.44 vs 1.37±1.36、75.83±37.22 vs 43.78±34.45、633.17±174.75 vs 122.47±32.25(P<0.05)。结论 Th1和Th2型细胞因子都参与了HCV慢性化的进程,IL-2、IL-5、及IL-18在导致HCV感染慢性化进程中可能起了一定的作用。展开更多
文摘AIM:To determine whether acoustic radiation force impulse(ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus(HCV) hepatitis.METHODS:We performed a multicenter study including 274 subjects with HCV chronic hepatitis in which we compared ARFI with liver biopsy(LB).In each patient we performed LB(evaluated according to the Metavir score) and ARFI measurements(using a Siemens Acuson S2000TM ultrasound system:10 valid measurements were performed and median values were calculated and expressed in meters/second(m/s).RESULTS:A direct,strong,correlation(Spearman r = 0.707) was found between ARFI measurements and fibrosis(P < 0.0001).For predicting the presence of fibrosis(F ≥ 1 Metavir),significant fibrosis(F ≥ 2),severe fibrosis(F ≥ 3) and cirrhosis(F = 4),the cutoff values of 1.19,1.21,1.58 and 1.82 m/s were determined,respectively,liver stiffness measurements had 73%,84%,84% and 91% Se respectively;93%,91%,94%,90% Sp,respectively;with AUROCs of 0.880,0.893,0.908 and 0.937,respectively.CONCLUSION:ARFI measurement is a reliable method for predicting the severity of fibrosis in HCV
基金Supported by PRIN grants from the Italian Ministry of Science and Technology, No. 2003063143-006
文摘AIM: To assess whether a correlation exists between oxidative DNA damage occurring in chronic HCV-related hepatitis and expression levels of pro-inflammatory cytokines, TGF-αand c-myc. METHODS: The series included 37 patients with chronic active HCV-related hepatitis and 11 with HCV-related compensated cirrhosis. Eight-hydroxydeoxyguanosine in liver biopsies was quantified using an electrochemical detector. The mRNA expression of TIMF-α, IL-1β, TGF-αand c-myc in liver specimens was detected by semi-quantitative comparative RT-PCR. RESULTS: TNF-αlevels were significantly higher in hepatitis patients than in cirrhosis patients (P=0.05). IL-1βwas higher in cirrhosis patients (P=0.05). A significant correlation was found between TNF-αand staging (P=0.05) and between IL-1βlevels and grading (P=0.04). c-myc showed a significantly higher expression in cirrhosis patients (P=0.001). Eight-hydroxydeoxyguanosine levels were significantly higher in cirrhosis patients (P=0.05) and in HCV genotype 1 (P=0.03). Considering all patients, 8-hydroxydeoxyguanosine levels were found to be correlated with genotype (P=0.04) and grading (P=0.007). Also multiple logistic regression analysis demonstrated a significant correlation among the number of DNA adducts, TNF-αexpression and HCV genotype (P=0.02). CONCLUSION: In chronic HCV-related liver damage, oxidative DNA damage correlates with HCV genotype, grading and TNF-αlevels. As HCV-related liver damage progresses, TNF-αlevels drop while IL-1βand c-myc levels increase, which may be relevant to liver carcinogenesis.
文摘The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 pa-tients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.
文摘BACKGROUND: The resolution of hepatitis C, evidenced by normalization of liver function and disappearance of hepatitis C virus RNA from serum as determined by conventional laboratory assays, reflects virus eradication. But in interferon treated patients the HCV RNA in serum sometimes could not show the virus in cells. Such factors as virus genotype, HCV RNA contents in serum, HCV specific cellular immunities after treatment were reported to predict the response to interferon therapy. In most patients, HCV RNA could detect the virus in peripheral blood mononucle-ar cell. The aim of this study was to investigate the predictive value of HCV RNA in PBMC of patients with chronic hepatitis C after interferon treatment. METHODS: Sixteen patients with chronic hepatitis C were treated with interferon for 24 weeks, and they all get complete responses at 12 weeks of treatment. At the end of treatment, the HCV RNA in PBMC and serum were detected by RT-PCR, and after stopping treatment, HCV RNA in serum was monitored continually. RESULTS: In 9 patients who were HCV RNA positive in their PBMC at the end of treatment, 8 showed serum HCV RNA positive after 24 weeks and another 1 after 1 year. In 7 patients with negative HCV RNA in their PBMC, only 2 patients relapsed in serum HCV RNA after 1-year follow-up, and others remained viral response after 3.5 years. CONCLUSION: HCV RNA in PBMC at the end of IFN treatment is a predictor of durable response to antiviral therapy in patients with chronic hepatitis C.
文摘Hepatitis C virus(HCV) infection is one of the mostfrequent causes of comorbidity and mortality in the human immunodeficiency virus(HIV) population, and liver-related mortality is now the second highest cause of death in HIV-positive patients, so HCV infection should be countered with adequate antiviral therapy. In 2011 began the era of directly acting antivirals(DAAs) and the HCV NS3/4A protease inhibitors telaprevir and boceprevir were approved to treat HCV-genotype-1 infection, each one in combination with pegylated interferon alfa(Peg-IFN) + ribavirin(RBV). The addition of the first generation DAAs, strongly improved the efficacy of antiviral therapy in patients with HCVgenotype 1, both for the HCV-monoinfected and HIV/HCV coinfected, and the poor response to Peg-IFN + RBV in HCV/HIV coinfection was enhanced. These treatments showed higher rates of sustained virological response than Peg-IFN + RBV but reduced tolerability and adherence due to the high pill burden and the several pharmacokinetic interactions between HCV NS3/4A protease inhibitors and antiretroviral drugs. Then in 2013 a new wave of DAAs arrived, characterized by high efficacy, good tolerability, a low pill burden and shortened treatment duration. The second and third generation DAAs also comprised IFN-free regimens, which in small recent trials on HIV-positive patients have shown comforting preliminary results in terms of efficacy, tolerability and adherence.
基金supported by a grant from National Health Department of China(2008ZX10005-009)Roche company
文摘Objective This study was undertaken to investigate the influencing factors on serum ALT level and hepatitis C virus(HCV)RNA titer in chronic hepatitis C(CHC)patients.Methods All patients enrolled into this study were anti-HCV positive.Retrospective tracing method was applied to detect serum ALT level and HCV RNA titer and to collect general information of the patients such as genders,age groups,interferon medication history,infection pathways,height and weight.Then the multi-factor analysis was adopted with the application of binominal logistic regression mode.Results The abnormal rate of ALT level was positively correlated to HCV RNA and gender while negatively correlated to interferon medication history and age group,with Wald value of the 4 factors as 39.604,11.823,18.991 and 7.389,respectively.The positive rate of HCV RNA was negatively correlated to interferon medication history and gender while positively correlated to ALT level,with corresponding Wald value of the 3 factors as81.394,7.618 and 27.562,respectively.Conclusions The normal ALT level in HCV infected patients was associated with viral load,age,gender and interferon medication history,while the normal rate of HCV RNA titer was closely associated with gender,interferon medication history and ALT level.
文摘目的探讨慢性HCV感染者感染慢性化产生与白细胞介素(IL)家族细胞因子含量变化的关系。方法收集慢性HCV感染者及健康人群的血液标本各40人份,ELISA法检测血液中IL-2、IL-4、IL-5、IL-6、IL-12、IL-18细胞因子含量变化。结果 HCV感染者和健康人群的IL-2、IL-5、IL-18(pg/m L)分别为:0.28±0.44 vs 1.37±1.36、75.83±37.22 vs 43.78±34.45、633.17±174.75 vs 122.47±32.25(P<0.05)。结论 Th1和Th2型细胞因子都参与了HCV慢性化的进程,IL-2、IL-5、及IL-18在导致HCV感染慢性化进程中可能起了一定的作用。
