Document Detail


The effect of angiotensin-blocking agents on liver fibrosis in patients with hepatitis C.
MedLine Citation:
PMID:  19220742     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multiple studies implicate the renin-angiotensin system in hepatic fibrogenesis. Few studies have examined the effects of angiotensin blockade on liver fibrosis via human histology.
AIMS: We studied the histological effect of angiotensin II blocking agents in chronic hepatitis C patients.
METHODS: This was a retrospective study of 284 chronic hepatitis C patients from 2001 to 2006 who underwent a liver biopsy. Group I was comprised of 143 hypertensive patients who received angiotensin-blocking agents. Group II was comprised of 91 hypertensive subjects who received hypertensive agents other than angiotensin blockers. Group III was comprised of 50 non-hypertensive subjects.
RESULTS: The groups were similar in age, sex, hepatitis C genotype, viral load and disease duration. They varied significantly in total diabetic patients (Group I, 43; Group II, 10; Group III, 1; P=0.0001), consistent with recommended use of angiotensin-converting enzyme inhibitors in hypertensive diabetics. Non-hypertensive patients had significantly less fibrosis than hypertensive patients, regardless of antihypertensive medications (Group I, 3.20; Group II, 3.73; Group III, 2.5; P=0.0002). Group I had significantly less fibrosis than Group II (P=0.02). This finding persisted in a non-diabetic subgroup of Groups I and II (Group I, 3.07; Group II, 3.69; P=0.0129).
CONCLUSION: Patients with hepatitis C and hypertension have increased fibrosis compared with non-hypertensive patients. Hypertensive patients receiving angiotensin-blocking agents had less fibrosis than hypertensive patients who did not receive angiotensin-blocking agents. This suggests an association with hypertension, possibly via the renin-angiotensin system in the fibrosis development and suggests a beneficial role of angiotensin II blockade in hepatitis C virus-related fibrosis.
Authors:
Kathleen E Corey; Nirali Shah; Joseph Misdraji; Barham K Abu Dayyeh; Hui Zheng; Atul K Bhan; Raymond T Chung
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2009-02-09
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  29     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-05     Completed Date:  2009-08-10     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  748-53     Citation Subset:  IM    
Affiliation:
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Female
Hepatitis C / complications*
Humans
Hypertension / drug therapy*
Liver Cirrhosis / drug therapy*,  etiology
Male
Massachusetts
Middle Aged
Retrospective Studies
Grant Support
ID/Acronym/Agency:
AI069939-01/AI/NIAID NIH HHS; DK078722/DK/NIDDK NIH HHS; K24 DK078772-01/DK/NIDDK NIH HHS; R01 AI069939-03/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections
Comment In:
Liver Int. 2009 Nov;29(10):1597; author reply 1598   [PMID:  19744164 ]
Liver Int. 2010 Feb;30(2):334-5   [PMID:  19515217 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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