Practice guidelines for the treatment of hepatitis C: Recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting

Prati, Daniele; Gasbarrini, Antonio; Mazzotta, Francesco; Sagnelli, E.; Carosi, Giampiero; Abrescia, Nicola G. A.; Alberti, Alfredo; Ambu, Silvia; Andreone, Pietro; Andriulli, Angelo; Angélico, M.; Ascione, Antonio; Belli, Luca; Bruno, Raffaele; Bruno, Savino; Burra, Patrizia; Cammà, Calogero; Caporaso, N.; Castaldo, Giuseppe; Cillo, Umberto; Coppola, Nicola; Craxı̀, Antonio; Luca, Andrea De; Martin, Eléonora De; Marco, Vito Di; Fagiuoli, Stefano; Ferrari, Carlo; Gaeta, Giovanni Battista; Galli, Massimo; Grieco, Antonio; Grossi, Paolo; Licata, Anna; Maida, Ivana; Mangia, Alessandra; Marino, Nicoletta; Maserati, Renato; Missale, Gabriele; Mondelli, Mario U.; Nasta, Paola; Niro, Grazia; Persico, Marcello; Petrelli, Enzo; Picciotto, A.; Piscaglia, Fabio; Pollicino, Teresa; Puoti, Claudio; Puoti, Massimo; Raimondo, Giovanni; Rumi, Maria Grazia; Santantonio, T.; Smedile, Antonina; Squadrito, Giovanni; Svegliati‐Baroni, Gianluca; Taliani, Gloria; Tavio, Marcello; Toti, M; Bonino, Ferruccio; Brunetto, Maurizia Rossana; Cacopardo, Bruno; Caremani, Marcello; Cauda, Roberto; Colombo, Massimo; Perri, Giovanni Di; Donato, Francesco; Farci, Patrizia; Fattovich, Giovanna; Filice, G.; Ghinelli, F; Guadagnino, Vincenzo; Lazzarin, Adriano; Levrero, Massimo; Licata, Giuseppe; Orani, Anna Maria; Paffetti, Amerigo; Pastore, Giuseppe; Piccinino, F; Pizzigallo, Eligio; Pontisso, Patrizia; Portelli, V.; Rizzetto, M.; Rossi, Alessandro; Stroffolini, Tommaso; Ubaldi, Enzo; Santantanio, Teresa; Antonucci, Giorgio

doi:10.1016/j.dld.2009.08.001

Cited by 55 publications

(11 citation statements)

References 67 publications

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“…Besides the CB2-63 QQ variant, the multivariate analysis identified another three factors independently associated with the PNALT status: HCV genotype 2, an older age and a lower BMI. HCV genotype 2 and a lower BMI have been suggested as independent predictors of PNALT in previous studies [10], [30], [31], and confirmed in the present investigation. Instead, this is the first time the CB2-63 QQ variant and an older age have been cited as independent predictors of the PNALT status.…”

Section: Discussionsupporting

confidence: 89%

“…Some individuals show a mild indolent clinical course for decades, others rapidly progress to end-stage liver disease [9], whereas about 20–30% of cases remain asymptomatic with normal serum alanine aminotransferase (ALT) levels lifelong. According to the Italian guidelines, the definition of an anti-HCV carrier with persistently normal ALT (PNALT) serum values applies to a subject with at least 9 consecutive ALT normal values observed at two-monthly intervals over an 18-month observation period[10]and identifies a subclinical form of CHC. The majority of carriers with PNALT show histological evidence of necroinflammation and fibrosis, but the liver lesions are clearly less severe than those observed in subjects with abnormal ALT [11], [12].…”

Section: Introductionmentioning

confidence: 99%

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Cannabinoid Receptor 2-63 QQ Variant Is Associated with Persistently Normal Aminotransferase Serum Levels in Chronic Hepatitis C

et al. 2014

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Background and AimTo evaluate in anti-HCV-positive patients the clinical impact of the rs35761398 variant of the CNR2 gene leading to the substitution of Gln (Q) of codon 63 of the cannabinoid receptor 2 (CB2) with Arg (R).Patients and Methods253 consecutive anti-HCV-/HCV-RNA-positive patients were enrolled, of whom 53 were HCV carriers with persistently normal ALT (PNALT group) and 200 had a history of steadily abnormal serum ALT values (abnormal ALT group). All patients were naive for antiviral therapy and were screened for the CNR2 rs35761398 polymorphism by a TaqMan assay.ResultsSubjects in the PNALT group, compared with those in the abnormal ALT group were older (58.5±12 vs. 50.7±12.4 years, p = 0.001), more frequently female (66% vs. 42%, p = 0.003), with lower body massindex (BMI) (24.5±3.1 vs. 26.6±4.6, p = 0.003), and more frequently with HCV genotype 2 (43.1% vs 17.7%, p = 0.0002) and CB2-63 QQ variant (34% vs. 11%, p = 0.0001). Considering all 253 patients, no difference in the demographic, biochemical, or virological data was observed between patients in the different CB2-63 variants. The logistic regression analysis identified CB2-63 QQ, HCV genotype 2, older age and lower BMI as independent predictors of PNALT (p<0.00001).DiscussionThe CB2-63 QQ variant in HCV patients was independently associated with the PNALT status.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Cannabinoid Receptor 2-63 QQ Variant Is Associated with Persistently Normal Aminotransferase Serum Levels in Chronic Hepatitis C

et al. 2014

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“…Of the 475 enrolled patients, 83 (17.4%) were HCV carriers with persistently normal alanine-aminotransferase serum values (PNALT) and 392 (82.6%) had a history of steadily abnormal serum ALT values. According to the Italian guidelines [28], the definition of an anti-HCV carrier with PNALT serum values applies to a subject with at least 9 consecutive ALT normal values observed at 2-monthly intervals over an 18-month observation period, while the definition of chronic hepatitis C to a subject with abnormal ALT values in absence of other causes. A complete history with possible route of infection and standard biochemical liver function tests were collected.…”

Section: Methodsmentioning

confidence: 99%

Distribution Pattern of Hepatitis C Virus Genotypes and Correlation with Viral Load and Risk Factors in Chronic Positive Patients

et al. 2014

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Objective: Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. The purpose of this study was to describe the distribution pattern of HCV genotypes in chronic hepatitis patients in the Campania region of southern Italy and estimate their association with risk factors and viral load. Materials and Methods: 404 consecutive HCV ribonucleic acid-positive patients were included in the study. HCV genotyping was carried out by the HCV line probe assay test and viral load estimation by the TaqMan real-time PCR system. Results: The predominant genotype was 1 (63.6%), followed by genotype 2 (29.4%), 3 (6.2%) and 4 (0.8%). Subtype 1b was more frequent in females than in males. Conversely, genotype 3 was more frequent in males. No significant difference was observed in age distribution of HCV genotypes. Surgery and dental therapy were the most frequent risk factors for genotype 1 and intravenous drug abuse and tattooing for genotype 3. Patients with genotype 1 more frequently showed high HCV viral load when compared to those with genotypes 2 and 3. Conclusion: The present study revealed that HCV genotypes 1 and 2 accounted for over 95% of all HCV infections in the Campania region, and genotype 1 was more frequently associated with a higher viral load when compared to genotypes 2 and 3.

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“…Genotypes 2 and 3 are recognized less frequently among CHC patients from the KSA (5, 11). The current standard treatment for CHC is the combination of pegylated interferon (PEG-INF) and ribavirin for 48 weeks for genotypes 1 and 4, and 24 weeks for genotypes 2 and 3 (7, 8, 12-14). This treatment is effective in up to 70-95% of patients with genotypes 2 and 3, 44-54% of patients with genotype 1, and 58-86% of patients with genotype 4 (7, 8, 12, 14-17).…”

Section: Introductionmentioning

confidence: 99%

Chronic Hepatitis C in Saudi Arabia: Three Years Local Experience in a University Hospital

Akbar¹,

Ghamdi

Qattan

et al. 2012

Hepat Mon

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BackgroundChronic hepatitis C (CHC) is a global infection. In Saudi Arabia, the prevalence of CHC is declining due to the implementation of a blood screening program. However, CHC still remains a leading cause of liver cirrhosis and hepatocellular carcinoma.ObjectivesThis is a retrospective study of CHC patients at the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.Patients and MethodsOut of a total of 291 CHC patients from the hepatology clinic at King Abdul Aziz University hospital, Jeddah, 279 patients were included in the present study. They were primarily male (152, 54.5%), with a mean age of 50.41 ± 1.72 years. The majority of patients were either Saudi (108, 38.7%) or Egyptian (60, 21.5%). A total of 61 patients received combination treatment with pegylated interferon and ribavirin, and one patient with sickle-cell anemia received pegylated INF monotherapy. Demographic, clinical and laboratory features of the CHC patients, and their responses to treatment were studied.ResultsDecompensated cirrhosis was documented in 60 patients (21.5%), and hepatocellular carcinoma in 14 (5%). The mean level of serum alanine aminotransferase was 83.6 ± 231 u/L. The predominant genotype among the 70 patients tested, was genotype 4, followed by genotype 1 (39 and 18 patients, respectively). The sustained viral response (SVR) rate was 82.99%. The main predictive factors for SVR were baseline HCV viral load and rapid virologic response (RVR). The mean duration of follow-up was 4.2 ± .85 years. There were 24 patients who had liver disease-related mortality.Conclusionsour data showed that 22% of CHC patients progress to cirrhosis and another 22% had treatment. Liver related mortality was more common in patients with advanced cirrhosis.

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Practice guidelines for the treatment of hepatitis C: Recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting

Cited by 55 publications

References 67 publications

Cannabinoid Receptor 2-63 QQ Variant Is Associated with Persistently Normal Aminotransferase Serum Levels in Chronic Hepatitis C

Cannabinoid Receptor 2-63 QQ Variant Is Associated with Persistently Normal Aminotransferase Serum Levels in Chronic Hepatitis C

Distribution Pattern of Hepatitis C Virus Genotypes and Correlation with Viral Load and Risk Factors in Chronic Positive Patients

Chronic Hepatitis C in Saudi Arabia: Three Years Local Experience in a University Hospital

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