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| 1 | Vitamin D supplementation improves sustained virologic response in chronic hepatitis C (genotype 1)-nave patients显示文摘AIM: To determine whether adding vitamin D, a potent immunomodulator, improves the hepatitis C virus (HCV) response to antiviral therapy. METHODS: Seventy-two consecutive patients with chronic HCV genotype 1 were randomized into two groups: the treatment group (n = 36, 50% male, mean age 47 ± 11 years) received Peg-α-2b interferon (1.5 μg/kg per week) plus ribavirin (1000-1200 mg/d) together with vitamin D3 (2000 IU/d, target serum level > 32 ng/mL), and the control group (n = 36, 60% male, mean age 49 ± 7 years) received identical therapy without vitamin D. HCV-RNA was assessed by realtime polymerase chain reaction (sensitivity, 10 IU/mL). The sustained virologic response (SVR) was defined as undetectable HCV-RNA at 24 wk post-treatment. RESULTS: Clinical characteristics were similar in both groups. The treatment group had a higher mean bodymass index (27 ± 4 kg/m2 vs 24 ± 3 kg/m2, P < 0.01), viral load (50% vs 42%, P < 0.01), and fibrosis score (> F2: 42% vs 19%, P < 0.001) than the controls. At week 4, 16 (44%) treated patients and 6 (17%) controls were HCV-RNA negative (P < 0.001). At week 12, 34 (94%) treated patients and 17 (48%) controls were HCV-RNA negative (P < 0.001). At 24 wk post-treatment (SVR), 31 (86%) treated patients and 15 (42%) controls were HCV-RNA negative (P < 0.001). Viral load, advanced fibrosis and vitamin D supplementation were strongly and independently associated with SVR (multivariate analysis). Adverse events were mild and typical of Peg-α-2b/ribavirin. CONCLUSION: Adding vitamin D to conventional Peg-α-2b/ribavirin therapy for treatment-na■ve patients with chronic HCV genotype 1 infection significantly improves the viral response. | Saif Abu-Mouch Zvi Fireman Jacob Jarchovsky Abdel-Rauf Zeina Nimer Assy Liver Unit | 2011 | World Journal of Gastroenterology2011，17，47： | 29 |
| 2 | Clinical features of nonalcoholic fatty liver disease-associated hepatocellular carcinoma显示文摘BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), especially nonalcoholic steatohepatitis, is a recognized risk factor for hepatocellular carcinoma (HCC). However, detailed analysis of the clinical features in patients with NAFLD and their association with HCC is lacking. This study aimed to update the clinical features of patients with NAFLD-associated HCC. DATA SOURCES: The clinical data of patients with NAFLD- associated HCC from 25 studies published between 1990 and 2010 in the Pubmed database were comprehensively reviewed. RESULTS: In a total of 169 patients with NAFLD-associated HCC, 72.8% were male. The median age at abnormal liver function tests and diagnosis of NAFLD and HCC was 60, 64 and 67 years, respectively. Most patients were obese (75%) and diabetic (59.8%), 32.3% had dyslipidemia, and 53% had hypertension. Nearly all patients (98.6%, 71/72) were complicated with at least one metabolic disorder. The majority (76%) of the HCC patients had a solitary tumor nodule, with the tumor size ranging from 0.8 to 20 cm in diameter (mean 3.4 cm). Most (61.1%) of the patients had moderately-differentiated HCC. In 40.2% of the patients, HCC occurred in the absence of cirrhosis. Among 130 patients, 57.7% underwent hepatectomy and 14.6% received liver transplantation. The mean follow-up of the treated patients for 25 months showed that 32.4% (24/74) died and 18.8% (9/48) had recurrence. CONCLUSIONS: Patients with NAFLD-associated HCC are usually accompanied with metabolic disorders. Regular surveillance in patients with NAFLD for HCC is necessary, especially for elderly men with metabolic syndrome. | Xiao-Yan Duan, Liang Qiao and Jian-Gao Fan Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China Storr Liver Unit at the Westmead Millennium Institute, the University of Sydney at Westmead Hospital, Westmead, NSW 2145, Australia | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 16 |
| 3 | Lamivudine does not increase the efficacy of interferon in the treatment of mutant type chronic viral heaptitis B显示文摘AIM:To study the role of lamivudine in improving the efficiency of interferon for the treatment of mutant type chronic hepatits B.METHODS:Fifteen patients with mutant type chronic hepatitis Bwere prospectively studied.All patients had liver histology and serology to prove the diagnosis of chronic hepatitis B.Each patient received4.5millionunits of interferon alpha-2a thrice weekly and 100mg of oral lamivudine daily for 24weeks.Patents were observed and tested for blood chemistry every week for the initial 4weeks and every 2weeks thereafter during the treatment until 24weeks.After the end of treatment,patients were followed up at4-week intervals for an additional6months,SerumHBVDNAlevels were tested using the liquid phase molecular hybridization assay.Those with non-detectable HBVDNA were also tested using the real-time polymerase chain reaction.One patient,who did not finish treatment due to depression.was excluded.RESULTS:At the end of treatment.7(50%)patients had serum ALTlevels within normal limits:12(86%)patients had serumHBVDNAlevels<5pg/mLusing the liquid phase molecular hybridization assay,but only8(67%)were<20copies/dL using the real-time polymerase chain reaction Six months after treatment only two(14%)patents had a susained complete response to the combination therapy with serum ALTlevel<35iu/Land undetectable serum HBVDNA levels.CONCLUSION:These pilot data showed that lamivudine did not increase the efficacy of interferon in the treatment of mutant type chronic hepatitsB.The liquid phase molecular hbridization assay was not sensitive enough to detect the lov HBVDNAlevels during combined interferon and lamivudine therapy. | Sien-Sing Yang Jui-Ting Hu Yung-Chih Lai Chi-Hwa Wu Liver Unit,Cathay General Hospital,Taipei,Taiwan,China Sien-Sing Yang Chao-Tien Hsu Medical Faculty,China Medical College and Hospital,Taichung,Taiwan,China | 2002 | World Journal of Gastroenterology2002，8，5： | 5 |
| 4 | Recommendations for alcohol-related liver disease 显示文摘 | Bathgate A J for UK Liver Transplant Units | 2006 | Lancet2006，367，9528： | 1 |
| 5 | Model for end-stage liver disease (MELD) and allocation of donor livers显示文摘 | Wiesner R Edwards E Freeman R United Network for Organ Sharing Liver Disease Severity Score | 2003 | Gastroenterology2003，124，1： | 1 |
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