Document Detail


Effects of long-term course of alpha-interferon in patients with chronic hepatitis C associated to mixed cryoglobulinaemia.
MedLine Citation:
PMID:  9431896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the efficacy of a long-term course of alpha-interferon (alpha-IFN) in the treatment of HCV-related mixed cryoglobulinaemia and to determine the impact of cryoglobulinaemia on therapeutic response to IFN in chronic hepatitis C (CHC) patients. DESIGN: Prospective controlled study. SETTING: University Medical Centre. PARTICIPANTS: Ninety consecutive CHC patients, 50 with cryoglobulinaemia (25 symptomatic and 25 asymptomatic; median cryocrit, 8%; chronic persistent hepatitis (CPH) 7, chronic active hepatitis (CAH) 27, cirrhosis 16) and 40 without cryoglobulinaemia (CPH 6, CAH 20, cirrhosis 14). HCV genotypes in the cryoglobulinaemic and non-cryoglobulinaemic groups were: 1b 40% and 45%; 2a 40% and 30%; others 20% and 25%, respectively. INTERVENTIONS: Twelve-month course of alpha-IFN 2a, 3 MU, three times weekly. MAIN OUTCOME MEASURES: Disappearance of cryoglobulinaemia and related syndrome, clearance of serum HCV RNA and normalization serum transaminase levels at the end of treatment (response) and after 12 months follow-up (sustained response). RESULTS: Overall, cryoglobulinaemic patients showed a similar response to IFN to those without cryoglobulinaemia (44% vs. 42.5%, respectively). In the cryoglobulinaemic group, symptomatic patients showed a lower response rate than asymptomatic patients (28% vs. 60%, respectively; P<0.05). HCV genotype 2a/c, absence of cirrhosis and a low cryocrit (<9%) were predictive factors of high response rate to IFN. Sustained response in non-cryoglobulinaemic patients (22.5%) tended to be higher than in patients with symptomatic cryoglobulinaemia (4%), as well as among patients carrying genotype 2a/c (67% vs. 10%, respectively; P<0.02). IFN was effective in controlling purpura (80%) but was moderately effective on severe haematuria/proteinuria, renal insufficiency and neuropathy. CONCLUSIONS: A 12-month course of alpha-IFN is effective treatment for HCV-related cryoglobulinaemia. However, patients with CHC associated to symptomatic cryoglobulinaemia have a lower response rate to IFN.
Authors:
L E Adinolfi; R Utili; R Zampino; E Ragone; G Mormone; G Ruggiero
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  9     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-02-11     Completed Date:  1998-02-11     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1067-72     Citation Subset:  IM    
Affiliation:
Institute of Medical Therapy, Second University of Naples Medical School, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cryoglobulinemia / diagnosis,  drug therapy*
Female
Follow-Up Studies
Genotype
Hepatitis C / diagnosis,  genetics,  therapy*
Hepatitis, Chronic / diagnosis,  drug therapy*,  genetics
Humans
Interferon-alpha / adverse effects,  therapeutic use*
Male
Middle Aged
Prognosis
Prospective Studies
RNA, Viral / blood
Treatment Outcome
Chemical
Reg. No./Substance:
0/Interferon-alpha; 0/RNA, Viral
Comments/Corrections
Comment In:
Eur J Gastroenterol Hepatol. 1997 Nov;9(11):1063-5   [PMID:  9431895 ]

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