Showing papers by "Raffaele Bruno published in 2011"
University of Milan1, University of Udine2, University of Florence3, University of Bari4, University of Pavia5, University of Padua6, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico7, University of Brescia8, Sapienza University of Rome9, University of Pisa10, University of Modena and Reggio Emilia11
TL;DR: A core set of recommendations for the treatment of HCV-associated mixed cryoglobulinemia syndrome is defined by combining current evidence from clinical trials and expert opinion, and may be useful as provisional guidelines for the management of MCS.
179 citations
TL;DR: Aliment Pharmacol Ther 2011; 33: 1162–1172.
Abstract: Aliment Pharmacol Ther 2011; 33: 1162–1172
Summary
Background Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma and the identification of the predictors of response to antiviral therapy is an important clinical issue.
Aim To determine the independent contribution of factors including IL28B polymorphisms, IFN-gamma inducible protein-10 (IP-10) levels and the homeostasis model assessment of insulin resistance (HOMA-IR) score in predicting response to therapy in chronic hepatitis C (CHC).
Methods Multivariate analysis of factors predicting rapid (RVR) and sustained (SVR) virological response in 280 consecutive, treatment-naive CHC patients treated with peginterferon alpha and ribavirin in a prospective multicentre study.
Results Independent predictors of RVR were HCV RNA <400 000 IU/mL (OR 11.37; 95% CI 3.03–42.6), rs12980275 AA (OR 7.09; 1.97–25.56) and IP-10 (OR 0.04; 0.003–0.56) in HCV genotype 1 patients and lower baseline γ-glutamyl-transferase levels (OR = 0.02; 0.0009–0.31) in HCV genotype 3 patients. Independent predictors of SVR were rs12980275 AA (OR 9.68; 3.44–27.18), age <40 years (OR = 4.79; 1.50–15.34) and HCV RNA <400 000 IU/mL (OR 2.74; 1.03–7.27) in HCV genotype 1 patients and rs12980275 AA (OR = 6.26; 1.98–19.74) and age <40 years (OR 5.37; 1.54–18.75) in the 88 HCV genotype 1 patients without a RVR. RVR was by itself predictive of SVR in HCV genotype 1 patients (OR 33.0; 4.06–268.32) and the only independent predictor of SVR in HCV genotype 2 (OR 9.0, 1.72–46.99) or genotype 3 patients (OR 7.8, 1.43–42.67).
Conclusions In HCV genotype 1 patients, IL28B polymorphisms, HCV RNA load and IP-10 independently predict RVR. The combination of IL28B polymorphisms, HCV RNA level and age may yield more accurate pre-treatment prediction of SVR. HOMA-IR score is not associated with viral response.
90 citations
TL;DR: In an analysis of HIV-infected patients with acute hepatitis C, it was found that the IL28B genotype was associated with serum levels of hepatitis C virus RNA, g-GT, and CD4 cell count, but not with treatment response rates.
Abstract: Recently, a IL28B (rs 12979860) gene polymorphism was identified as a predictor for response to hepatitis C virus-specific treatment in human immunodeficiency virus (HIV)-uninfected and -infected patients with chronic hepatitis C. In an analysis of HIV-infected patients with acute hepatitis C, we found that the IL28B genotype was associated with serum levels of hepatitis C virus RNA, g-GT, and CD4 cell count. In contrast to HIV-infected patients with chronic hepatitis C, the IL28B genotype was not significantly associated with treatment response rates in patients with acute hepatitis C. Thus, effects of the IL28B single-nucleotide polymorphism may differ in HIV-infected patients with chronic and acute hepatitis C.
54 citations
TL;DR: The Italian recommendations for the therapy of hepatitis B virus (HBV)-related disease were issued in 2008 and the introduction of the nucleotide analogue (NA) Tenofovir was approved for antiviral treatment, which includes some additional revisions.
36 citations
TL;DR: This study aims to investigate the independent association between the homeostasis model assessment of the insulin resistance (HOMA‐IR) score and rapid virological response (RVR) and sustained virol logical response (SVR) in chronic hepatitis C (CHC).
Abstract: To investigate the independent association between the homeostasis model assessment of the insulin resistance (HOMA-IR) score and rapid virological response (RVR) and sustained virological response (SVR) in chronic hepatitis C (CHC)
34 citations
TL;DR: Along with screening of patients at risk and an early diagnosis, aggressive treatment of the neoplasia including treatment of relapses and maintenance of HIV suppression are the best management strategies for HCC in PLHIV.
Abstract: Purpose of reviewRecent data showed that in some settings with adequate resources liver diseases rank first among the causes of death in persons living with HIV (PLHIV). Although liver decompensation is the first cause of hepatic death in PLHIV, hepatocellular carcinoma (HCC) is also emerging as one
18 citations
TL;DR: Agents that specifically target the replication cycle of the virus direct-acting antiviral agents by directly inhibiting the NS3/4A serine protease, the NS5B polymerase and NS5A are currently in clinical development.
11 citations
TL;DR: This study evaluated 92 consecutive patients with symptomatic AH to assess how LSM was influenced by aetiology, and whether LSM kinetics correlated with the clinical course of AH.
Abstract: We read with interest the lead article by Castera and Pinzani,1 particularly the comment regarding the role of transient elastography (TE) in the context of acute hepatitis (AH).
The assumption that liver stiffness is determined exclusively by hepatic fibrosis has been challenged by evidence that patients with AH can have high values of liver stiffness measurement (LSM) by TE.2 AH is a suitable model for studying the kinetics of LSM, since inflammation and necrosis increase rapidly and sometimes massively, but may revert with equal speed.
We evaluated 92 consecutive patients (mean age 41.8±16.3 years, 71.7% males) with symptomatic AH to assess how LSM was influenced by aetiology, and whether LSM kinetics correlated with the clinical course of AH. Twelve patients (13%) had …
10 citations
01 Jan 2011
TL;DR: The Italian recommendations for the therapy of hepatitis B virus (HBV)-related disease were issued in 2008 and the introduction of the nucleotide analogue (NA) Tenofovir was approved for antiviral treatment, which includes some additional revisions.
Abstract: The Italian recommendations for the therapy of hepatitis B virus (HBV)-related disease were issued in 2008. Subsequently in 2008 the nucleotide analogue (NA) Tenofovir was approved for antiviral treatment. The introduction of this important new drug has called for the current guidelines update, which includes some additional revisions: (a) the indication for therapy is extended to mild liver fibrosis and the indication for treatment is graded as “possible”, “optional” or “mandatory” according to the fibrosis stage; (b) two different treatment strategies are described: first line definite duration treatment with interferon, long-term treatment of indefinite duration with NA; (c) the indication to follow either strategy is also based on the stage of liver fibrosis; (d) virological monitoring is modified to include the definitions of failure and of sustained virological response to interferon therapy; (e) the recommendation to use HBV DNA assays with high sensitivity and wide linear ranges is underlined (f) guidelines on post-treatment follow-up after finite treatment with NA, potential side effects of therapy and non-virological monitoring are defined; (g) definitions and treatment of patients without optimal response to NA are reported; (f) treatment and monitoring of compensated or decompensated cirrhosis and hepatocellular carcinoma are updated.
8 citations
4 citations
TL;DR: Both telaprevir (TVR) and boceprevir (BOC) are potent inhibitors of the NS3/4A serine protease; both have been tested in combination with the standard-of-care (SOC; peginterferon plus ribavirin) in large Phase III trials as mentioned in this paper.
Abstract: The advent of direct-acting antiviral agents (DAAs) active against different steps within the HCV lifecycle will dramatically change therapy, especially for difficult-to-treat patients. Both telaprevir (TVR) and boceprevir (BOC) are potent inhibitors of the HCV NS3/4A serine protease; both have been tested in combination with the standard-of-care (SOC; peginterferon plus ribavirin) in large Phase III trials. The pivotal Phase III trials that included TVR are ADVANCE