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      Efecto antifibrótico del interefrón alfa 2b recombinante en la cirrosis hepática por virus B o C Translated title: Antifibrotic effect of recombinant interferon alfa 2b in liver cirrhosis caused by virus B or C

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          Abstract

          Se evaluó el efecto antifibrótico del interferón alfa 2b recombinante utilizado durante un año (6 millones de U 3 veces a la semana) en pacientes con cirrosis hepática por virus B o C mediante estudios histológicos y de ecografía Doppler antes de concluido el tratamiento y después. Se valoró el perfil bioquímico hepático durante ese año. Participaron en la investigación 10 pacientes. Se encontró en el análisis global del método morfométrico aplicado al estudio histológico y en la ecografía Doppler que no hubo disminución estadísticamente significativa de la fibrosis hepática, pero individualmente disminuyó en 3 de los enfermos tratados y se detuvo en uno. El método de evaluación semicuantitativo de la fibrosis en la biopsia hepática no mostró que se revirtiera el proceso fibrótico. Se detectó una mejoría estadísticamente significativa en las aminotranferasas. Se detectaron efectos adversos que coinciden con lo reportado en la literatura nacional e internacional revisada

          Translated abstract

          The antifibrotic effect of recombinant interferon alfa 2b used for a year (6 millions of U 3 times a week) in patients with liver cirrhosis caused by virus B or C was evaluated by histological studies and Doppler echography before and after concluding the treatment. The hepatic biochemical profile was assessed during that year. 10 patients participated in the research. In the global analysis of the morphometric method applied to the histological study and in the Doppler echography, it was found that there was no statistically significant reduction of liver fibrosis, but it individually decreased in 3of the patients treated and it stopped in one. The semiquantitative method for evaluating fibrosis in the liver biopsy did not show a reversion of the fibrotic process. A statistically marked improvement was observed in the aminotransferases. Adverse effects coinciding with what is reported in the national and international literature reviewed were detected.

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          Most cited references41

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          Classification of chronic viral hepatitis: a need for reassessment.

          P Scheuer (1991)
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            Efficacy of interferon treatment for patients with chronic hepatitis C: comparison of response in cirrhotics, fibrotics, or nonfibrotics.

            Chronic hepatitis C patients (472 patients) were treated with consensus interferon (CIFN) or interferon (IFN) alfa-2b for 6 months in a large multicenter trial. Efficacy was assessed by clearance of hepatitis C virus (HCV) RNA using reverse transcription polymerase chain reaction (RT-PCR) (<100 copies/mL), normalization of serum alanine aminotransferase (ALT), and histological improvement. The purpose of these analyses was to compare these efficacy parameters in nonfibrotics, fibrotics, and cirrhotics. Patients with chronic HCV and cirrhosis showed the same benefit from IFN treatment as noncirrhotic patients when efficacy was assessed by clearance of serum HCV RNA or by histological benefit. Sustained HCV RNA response rates were similar when measured among nonfibrotic (11%), fibrotic (13%), and cirrhotic (11%) patients. Improvement in histologic activity index (HAI) scores was noted among all 3 groups. Cirrhotic patients had a lower sustained ALT response rate (12%) than did nonfibrotic patients (23%). Ninety percent of nonfibrotics, but only 71% of fibrotics and 67% of cirrhotics, who sustained a virological response normalized their ALT. This suggests that cirrhotic patients may clear the hepatitis C virus without normalization of ALT levels. The pattern of both HCV RNA clearance over time and ALT decrease was similar among nonfibrotics, fibrotics, and cirrhotics. Tolerability to IFN therapy was similar among the 3 groups except that more cirrhotics required dose reduction because of thrombocytopenia. In patients with cirrhosis, ALT levels may be a less appropriate endpoint in the measurement of response to therapy. We conclude that liver cirrhosis should not be a reason for excluding patients from therapy because both cirrhotic and fibrotic HCV patients benefit from IFN therapy not only by clearance of virus but by improvements in liver histology.
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              Management of chronic hepatitis C: clinical audit of biopsy based management algorithm

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                med
                Revista Cubana de Medicina
                Rev cubana med
                ECIMED (Ciudad de la Habana )
                1561-302X
                August 2005
                : 44
                : 3-4
                : 0
                Affiliations
                [1 ] Hospital Clínico Quirúrgico Hermanos Ameijeiras Cuba
                Article
                S0034-75232005000400008
                f038704e-2bdc-45f0-91c4-a872d5007197

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0034-7523&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL
                MEDICINE, LEGAL
                MEDICINE, RESEARCH & EXPERIMENTAL

                Social law,Medicine,Internal medicine
                interferon,Liver cirrhosis,treatment,interferón,acción antifibrótica,antifibrotic action,Cirrosis hepática,tratamiento

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