| Effects of long-term course of alpha-interferon in patients with chronic hepatitis C associated to mixed cryoglobulinaemia. | |
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MedLine Citation:
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PMID: 9431896 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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L E Adinolfi; R Utili; R Zampino; E Ragone; G Mormone; G Ruggiero |
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Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 9 ISSN: 0954-691X ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 1997 Nov |
Date Detail:
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Created Date: 1998-02-11 Completed Date: 1998-02-11 Revised Date: 2009-10-16 |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1067-72 Citation Subset: IM |
Affiliation:
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Institute of Medical Therapy, Second University of Naples Medical School, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Interferon-alpha; 0/RNA, Viral |
| Comments/Corrections | |
Comment In:
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Eur J Gastroenterol Hepatol. 1997 Nov;9(11):1063-5
[PMID:
9431895
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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