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A case-control histological study on the effects of phlebotomy in patients with chronic hepatitis C.
MedLine Citation:
PMID:  22002003     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to assess the actual effectiveness of long-term phlebotomy by comparing histological improvement (HI) in 69 Caucasian HCV-RNA-positive CHC patients undergoing phlebotomy or receiving an interferon-based therapy without virological response [nonresponders to interferon therapy(IBT-NR)]. METHODS: HI was defined by at least one point reduction of the staging score or, in the case of unchanged stage, by at least two points reduction of the grading score (Knodel's Activity Index) and was retrospectively evaluated by comparing two consecutive (56±28 months apart) liver biopsies from 30 phlebotomized and 39 IBT-NR patients. RESULTS: HI was observed in 15 of 30 (50%) patients treated with phlebotomy and in six of 39 (15%) IBT-NR subjects (P=0.002). Furthermore, AST, ALT, and GGT serum levels were significantly reduced only in phlebotomized patients (P≤0.003) at the time of the second biopsy. Univariate and multivariate analysis showed that histological grading score before therapy (P=0.001) and phlebotomy (P=0.002) were independently predictors of HI. CONCLUSION: HI induced by long-term phlebotomy effectively exceeds that spontaneously occurring in patients IBT-NR confirming the efficacy of iron depletion in attenuating CHC progression when other therapies have failed.
Authors:
Massimo Sartori; Silvano Andorno; Angelo Rossini; Renzo Boldorini; Cristina Bozzola; Stefania Carmagnola; Mario Del Piano; Emanuele Albano
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-13
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  -     ISSN:  1473-5687     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aGastroenterology Unit, AOU Maggiore della Carita' bDepartment of Medical Sciences, University of East Piedmont 'Amedeo Avogadro', Novara cHepatology Unit, AO Spedali Civili, Brescia, Italy.
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