acelasi text dar fara probleme la formatare:
AASLD Liver Meeting Abstract 1407:
Elevated ALT is only predictive for a sustained virological response to peginterferon in HBeAg-positive chronic hepatitis B patients with wildtype virus
B. E. Hansen1, 3; M. J. Sonneveld1; V. W. Wong2; H. Chan2; H. Chan2; H. L. Janssen1
1. Department Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
2. Gastroenterology and Hepatology, Prince of Wales Hospital, Hong Kong SAR, China.
3. Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
Background Elevated levels of ALT may signify an active immune response against HBeAg positive chronic hepatitis B (CHB), and confer an increased probability of response to peginterferon (PEG-IFN). Possibly, the presence of pre-core (PC) and core promoter (BCP) mutants may influence this association through a reduced susceptibility to an immune reaction against the virus.
Methods 263 HBeAg-positive CHB patients were treated with PEG-IFN ± lamivudine for 52 weeks. Combined response (HBeAg loss with HBV DNA <2,000 IU/mL) was assessed at 6 months post-treatment. Patients were classified at baseline as wildtype (WT) or non-WT (detectable mutant at PC (at G1896) or BCP (at A1762 and G1764) by Inno-Lipa line-probe assay.
Results All HBV genotypes were represented: A (28%), B (12%), C (24%) and D (33%). PC and/or BCP mutants were detected across all HBV genotypes, but were significantly (p<0.001) more present in genotype B (75%), C (88%) and D (90%) when compared to A (31%). ALT levels were similar across WT versus non-WT (3.7xULN versus 4.1xULN, p=0.30).
Combined response to PEG-IFN was associated with presence of WT, genotype A, low HBVDNA and older age, whereas the effect of ALT proved to be significantly different depending on WT or non-WT (p-value for interaction = 0.01, figure). Among WT patients ALT was a strong predictor (OR = 1.27, 95%CI: 1.02-1.57, p=0.03), while in the group of patients with non-WT the effect of ALT disappeared (OR = 0.96, 95%CI: 0.81-1.10, p=0.62).
Conclusions The role of ALT as a predictor to response to PEG-IFN depends on WT/non-WT HBV. High ALT levels is a strong predictor of response to PEG-IFN in HBeAg-positive CHB patients with only WT virus, whereas ALT levels do not predict response to PEG-IFN in patients with detectable PC and/or BCP mutants
Connny a scris:
Interesant. Poate mai citeste si altcineva (stim noi cine) ce se spune in studiul asta.
ar fi bine daca ar citii, ar fi un pas inainte in a acepta si alceva inafara propriilor idei (de multe ori preconcepute) ... pt stim noi cine as posta si un studiu (aceptat de AASL) despre un tratament bazat pe un exctract din gindaci (dinaia de bucatrie) :)
