From Gastroenterolgy -- Want Methadone Support??

[ Show ]

Support VoyForums

[ Shrink ]

VoyForums Announcement: Programming and providing support for this service has been a labor of love since 1997. We are one of the few services online who values our users' privacy, and have never sold your information. We have even fought hard to defend your privacy in legal cases; however, we've done it with almost no financial support -- paying out of pocket to continue providing the service. Due to the issues imposed on us by advertisers, we also stopped hosting most ads on the forums many years ago. We hope you appreciate our efforts.

Show your support by donating any amount. (Note: We are still technically a for-profit company, so your contribution is not tax-deductible.) PayPal Acct: Feedback:

Donate to VoyForums (PayPal):

[ Login ] [ Contact Forum Admin ] [ Main index ] [ Post a new message ] [ Search | Check update time | Archives: 1, 2, [3], 4 ]

[ Next Thread | Previous Thread | Next Message | Previous Message ]

Date Posted: 17:17:09 05/02/02 Thu
Author: Susie
Author Host/IP: bgp425870bgs.union01.nj.comcast.net / 68.36.197.75
Subject:

From Gastroenterolgy

Clinical Research
Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C
Thierry Poynard* [MEDLINE LOOKUP]
John McHutchison� [MEDLINE LOOKUP]
Michael Manns� [MEDLINE LOOKUP]
Christian Trepo|| [MEDLINE LOOKUP]
Karen Lindsay� [MEDLINE LOOKUP]
Zachary Goodman# [MEDLINE LOOKUP]
Mei�Hsiu Ling** [MEDLINE LOOKUP]
Janice Albrecht** [MEDLINE LOOKUP]

Background & Aims: Liver fibrosis is an important prognostic factor in patients with hepatitis C. The effect of pegylated (PEG) interferon alone or its combination with ribavirin on fibrosis has not been established.
Methods: We pooled individual data from 3010 naive patients with pretreatment and posttreatment biopsies from 4 randomized trials. Ten different regimens combining standard interferon, PEG interferon, and ribavirin were compared. The impact of each regimen was estimated by the percentage of patients with at least 1 grade improvement in the necrosis and inflammation (METAVIR score), the percentage of patients with at least 1 stage worsening in fibrosis METAVIR score, and by the fibrosis progression rate per year.
Results: Necrosis and inflammation improvement ranged from 39% (interferon 24 weeks) to 73% (optimized PEG 1.5 and ribavirin; P < 0.001). Fibrosis worsening ranges from 23% (interferon 24 weeks) to 8% (optimized PEG 1.5 and ribavirin; P < 0.001). All regimens significantly reduced the fibrosis progression rates in comparison to rates before treatment. The reversal of cirrhosis was observed in 75 patients (49%) of 153 patients with baseline cirrhosis. Six factors were independently associated with the absence of significant fibrosis after treatment: baseline fibrosis stage (odds ratio [OR] = 0.12; P < 0.0001), sustained viral response (OR = 0.36; P < 0.0001), age < 40 years (OR = 0.51; P < 0.001), body mass index < 27 kg/m2 (OR = 0.65; P < 0.001), no or minimal baseline activity (OR = 0.70; P = 0.02), and viral load < 3.5 millions copies per milliliter (OR = 0.79; P = 0.03).
Conclusions: PEG-interferon and ribavirin combination significantly reduces the rate of fibrosis progression in patients with hepatitis C.

Publishing and Reprint Information TOP

*Service d'H�pato-Gastroent�rologie, Groupe Hospitalier Piti�-Salp�tri�re, Universit� Paris VI, Paris, France; �Scripps Clinic and Research Foundation, Division of Gastroenterology/Hepatology, La Jolla, California; �Division of Gastroenterology and Hepatology, Medical School of Hannover, Hannover, Germany; ||Service d'H�pato-Gastroent�rologie, H�tel Dieu, Lyon, France; �Division of Gastrointestinal and Liver Disease, University of Southern California, Los Angeles, California; #Department of Hepatic and Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, DC; and **Schering-Plough Research Institute, Kenilworth, New Jersey
Received August 27, 2001.

Accepted January 3, 2002.

GASTROENTEROLOGY 2002;122:1303-1313

Address requests for reprints to: Professeur Thierry Poynard, Service d'H�pato-Gastroent�rologie Groupe Hospitalier Piti�-Salp�tri�re 47-83 Boulevard de l'H�pital, 75651 Paris, Cedex 13, France. e-mail: tpoynard@teaser.fr .
Supported by research grants from Schering Plough Research Institute, Kenilworth, New Jersey, by Direction de la Recherche Clinique Assistance Publique H�pitaux de Paris, by Association pour la Recherche contre le Cancer, and by Association pour la Recherche sur les Maladies Hepatiques Viroles, Paris, France.

� 2002 by the American Gastroenterological Association

[ Next Thread | Previous Thread | Next Message | Previous Message ]

Replies:

[> coooooooool..."significantly reduces"...i like that -- terry, 19:35:20 05/02/02 Thu (sg09.merr.com/209.83.14.140)

[ Edit | View ]

[> Reversal of cirrhosis in 75 patients? WOW!!!!! -- Perry, 10:41:55 05/03/02 Fri (netcache-1112.public.svc.webtv.net/209.240.222.32)

Good article, Susie......i LIKE the sound of that!

[ Edit | View ]

[> Good news for a change... -- Junobear, 22:40:32 05/03/02 Fri (216-220-251-161.midmaine.com/216.220.251.161)

The liver is better at regenerating itself than any other organ in the body -- but 'the conventional wisdom' before this study has always been that cirrhosis can be halted from progressing further but cannot reversed.

I questioned 'the conventional wisdom' because, logically, it does not make sense to me that on the one hand, the liver has this marvelous ability to regenerate itself -- but on the other hand, cirrhosis cannot be reversed. If enough live cells are left to compensate, enough live cells should also be left to be able to regenerate.

The doctors remove half the liver of the donor in a live donor transplant -- and within three to four weeks, the donor liver regenerates itself back to its normal size? But the same liver once cirrhotic [cirrhotic but compensating] is incapable of regenerating? It does not make sense to me that both of these statements can be true.

So, I think that Poynard is probably right that cirrhosis up to a certain 'point of no return' can be reversed.

[ Edit | View ]

[ Contact Forum Admin ]

Forum timezone: GMT-5
VF Version: 3.00b, ConfDB:
Before posting please read our privacy policy.
VoyForums^(tm) is a Free Service from Voyager Info-Systems.
Copyright © 1998-2019 Voyager Info-Systems. All Rights Reserved.