Portale Epatite e malattie del fegato
Sito Epatite C
Sito Epatite B
Sito Steatosi
Sito Cirrosi
Sito Tumori
Sito Trapianti
Nuovi Farmaci
Malattie autoimmuni

Digestive and Liver Disease

An International journal of Gastroenterology and Hepatology

Abstracts of the A.I.S.F. - Il alian Association for the Study of the Liver -
Annua! Meeting 2011
Rome, February 24th - 25th, 2011

Ul/ml by week 24, 48 and 96. Virologica] response was noi correlated with
HBeAg status or ADV resistance mutations at baseline. Disease related events
included 6 HCC (3 deaths), 4 OLTs (1 HCC. 3 ESLD) and 6 deaths (3HCC
and 3 ESLD). Mediati creatinine levels were 0.89+0.23 mg/di at baseline and
1.03+0.82 at 48 weeks. 1 patient showed a sharp rise in creatinine levels
at week 24 (NSAIDs use) that resolved. 4 patients had MDRD <50 and 2
patients had an MDRD < 60 with grade 1/2 hypophosphoremia. AH are on
treatment with adjusted TDF dosage. None of the remaining patients showed
creatinine levels > 1.5 mg/dl or creatinine elevation > 0.5 mg/di or MDRD
Conclusions: TDF shows significant and sustained antiviral activity against
HBV in patients who have failed lamivudine and are sub-optimal responders
to ADV.

A inulticenter prospective observational study to evaluate factors
influencing efficacy, tolerance and compliance t<> antiviral tretament with
interferon and ribavirin in daily clinical practice

V. Di Marco, L. Covolo, M . Levrero, M . Puoti, F Suter. G.B. Gaeta, C.Ferrari
G. Raimondo. G. Fattovich, T. Santantonio. A. Alberti, R. Bruno, C. Mussini.
M. Mondelli. F Donato, A. Craxì. on behalf of the Multicenter Italian Group
for the Study of Hepatitis C

Background: Virai factors and host factors cari influence the Sustained
Virologica! Response (SVR) to anti-HCV treatment.
Objectives: The primary aim of this prospective multicentre cohort study was
to report data on SVR and adherence to PEG-IFN and ribavirin in daily clinical
practice in patients with chronic hepatitis caused by HCV mono-infection or
with H IV co-infection.
Methods: Nai've patients with HCV mono-infection or with HIV co-infection
were enrolled in 12 Italian Centers. Before antiviral therapy, virologica!
characteristics, histological features, metabolic conditions. parameters regarding
HIV infection and anti-HlV therapy were collected. The frequencies of
IL2HB SNPs isK(M9I7 (SNP9/7) and rsMMMO (SNPSoO) ( I T . GTand GG
alleles and CC, CT and T I ' alleles, respectively) were analyzed. Associations
between virological and host characteristics with outcomes were assessed by
multivariate logistic regression analysis.
Results: We enrolled 853 patients (711 with HCV mono-infection and 142
patients with HIV co-infection). Patients with HCV mono-infection had more
frequently a moderate/severe inflammation (46% vs 18*7r. p<0.0001) bui less
frequently severe fibrosis or cirrhosis (18% vs 36%. p < 0.0001) as compared
to HCV/HIV patients. Infection with genotype 1 and genotype 2 was more
frequent in the HCV mono-infected group 155% vs 33% and 26% vs 5%.
respectively; p < 0.001) and genotype 3 was more frequent in patients with
HCV/HIV infection (48% vs 14% p < 0.001). Frequencies of SNP860 alleles
were CC 45%, CT 45%. T T 10% and CC 43%, CT 49% and T T 8% in HCV
mono-infected and HCV/HIV, respectively. Frequencies of SNP9/7 alleles
were TT 47%. TG 45%. GG 6% and T T 72%, TG 36%. GG 1% in HCV
mono-infected and HCV/HIV. respectively. SVR was achieved in 50% and
33% (p= 0.07) of genotype 1 patients. in 86% and 83% of genotype 2 patients
and 76% and 76% of genotype 3 patients. for the HCV mono-infected and
HCV/HIV groups, respectively. TT allele of SNP917 (OR 4.569: 95% CI
1.158-7.347; p < 0.001); CC allele SNP860 (OR 3.879: 95% CI 1.578-9.347;
p= 0.01) and genotypes 2 and 3 (OR 5.018: 95% CI 1.001-1.025: p<0.001)
were independently associated with achievement of SVR by multivariate
logistic regression analysis.
Conclusions: Our study confìrms the efficacy of PEG-IFN and Ribavirin
therapy in a large cohort of patients with chronic hepatitis C treated in daily
clinical practice and that the probabilily lo achieve an SVR is significantly
affected by virai genotypes and 1L28B SNPs.
Acknovvledgement: The study is suppoiled by a grant frolli the Agenzia
Italiana del Farmaco.

Treatment and productivity costs of chronic hepatic diseases

L. Scalone(1). R. Ciampichini(1), S. Fagiuoli(2) . 1 . Gardini(3) , L. Gaeta(4) .
A. Del Prete(2) , F. Fusco(1) . L.G. Mantovani(1-4)

(1)CHARTA Foundation, Milano;(2)Ospedali Riuniti, Bergamo; (3)EpaC ONLUS:
(4)Policlinico Hospital, University o/NapIes Federico II, Naples

Background and aim: as a result of successful treatments for chronic hepatic
diseases (CHDs). patients' life expectancy, but also the diseases prevalerne
and costs are increasing. However, societal costs for CHDs remain little
known. We assessed treatment and productivity costs of patients with CHDs
in ltaly.
Methods: A Cost-Of-Illness study was conducted on adult patients with
CHDs. Data on conventional and unconventional treatment and ori productivity
loss during the 6 months before enrolment in the study were analysed
on a preliminary sample of 356 patients. Costs were analysed front the
societal perspective (including patients. their caregivers, National-Health-
Service) and reported as mean €/patient-month (treatment cost) and mean
days/patient-monlh of work/school/usual activities lost by patients and their
family caregiver (productivity loss).
Results: Patients were 70% male, aged 19-84 (median=55) years: 24.2% has
hepatitis C, 23.6% cirrhosis, 21.3% hepatitis B. 20.2% had liver transplantation.
2.8% hepatic carcinoma, 2.0% had NASH, 1.4% hepatitis C&B, 4.5%
had other hepatic diseases. Overall, their treatment cosi 403€/patient-month:
9 1% for conventional drug treatment (79% to treat main condition. 9% to treat
related co-morbidities e.g., ascites, 3% for other reasons e.g., hypertension),
9% for unconventional treatment (homeopathy, preparation of herbs. specific
diet, mulli-vitamin produets). Patients who received liver transplantalion were
the most expensive (7816/patient-month), followed by patients with hepatitis
B&C (627£/month). then hepatitis B (398€/month), hepatitis C (293€/month).
Productivity loss corresponded to 6.8days/patient-month. mainly by transplanted
patients/caregivers (14.4 days/patient-nionth) and those with cirrhosis.
Discussion: CHDs sensitively contribute to the high cost and require appropriate
health techiiology valuations to guide stakeholders to linci optimal
diagnostic and treatment strategies.

Early liver steatosis during choline-deficient diet is associated with
altered distributìon of caveolin-1 (CAVI) within lipid droplets and
mitochondria in steatotic rat hepatocytes

M. Maslrodonato(1) , G. Calamita(2) . R. Rossi(3) . D. Mentimi(1) .
L. tronfiale(4), P. Porlincasa(4) . D. F e r r i (1) . G È . Liquori1

(1) Dept. of Animai & Envìronmental Biology and; : (2)General & Environmental
Physiology; (3)J Pathologìcal Anaiomy, Utb. of Ultrastructural Pathology;
(4)Dept. of Internai Medicine & Public Medicine, "Aldo Moro" University,
Bari, ltaly

The main structural protein of caveolae, caveolin-I (CAVI), is involved in
cliolesterol homeostasis. transeytosis. endocytosis, and sigila! transduction.
Caveolin-1 might also play an important role in hepatic lipidogenesis. We
investigated the distributìon of CAVI in non-alcoholic fatty liver disease, a
potentially evolutive condition characterized by metabolic over-accumulation
of intrahepatic triglycerides
Methods: Micro- macro-vesicular liver steatosis (without steatohepatitis) was
induced in adult rats fed a choline-deficient diet for 14 days. compared with
a control diet. Exact expression and subcellular distributìon of CAVI in
hepatocytes was assessed at iight/election microscopy. inimunohistochemical,
cytochemical techniques. and Western blotting.
Results: In control rat lipid droplets were 1.2±0.2% (microvesicular type). In
choline-deficient rats. percent of fat content was significantly higher than in
Controls ( 4 1 . 2 ± 2 . 2% equal to 32% of total lipids as microvesicles, P<0.01 ).
In the control liver caveolin-1 was mainly associated to the hepatocyte basolateral
plasma membrane of caveolaen (weak in the cytoplasmic region), sinusoids.
lateral domain, bile canaliculi, and Golgi complex. Fatty hepatocytes showed
reduced glycogen slores and a significantly increased expression of caveolin-1
around and within lipid droplets. A significant increase in gold paiticles was

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