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A Journal on Internal Medicine

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Minerva Medica 2000 July-August;91(7-8):141-6


language: Italian

Ursodeoxycholic acid in the treatment of chronic hepatitis C after interferon therapy

Porcaro G., Sannino C., Mastroianni M., Ciavattone A., Bartiromo D., Nascia S.


Interferon alfa is to day the only therapy of proven benefit for the treatment and control of chronic hepatitis C. Therefore only 25% of patients receive from it a sustained biochemical and serological response; often when the treatment is stopped there is a flare up of ALT and reapparence of HCV-RNA in the serum. The most common schedule is 6 MU t.i w. for twelve months; after this there is no codified treatment for relapse prevention. The aim of this study was to evaluate if ursodeoxycholic acid (UDCA) administration after a cycle of IFN therapy was able to prevent relapse of the disease. Methods. We studied 36 patients whose mean age was 31.5±5.7 affected by chronic hepatitis C and treated with IFN a for one year. Only twenty of them received an end term therapy response and were therefore enrolled in a double blind study with two arms: Arm A treated with UDCA 300 mg b. i. d. for twelve months and Arm B treated with placebo. ALT value and HVC-RNA levels were evaluated at baseline, during and after treatment. Results. Patients treated with UDCA showed a lower percentage of relapse in comparison with patients treated with placebo. Conclusions. This effect was probably due to a double mechanism: the first of biochemical type because a reduction in the intrahepatic concentration of hydrophobic biliary acids, the second immunological due to a lower expression of HLA class I and II antigens.

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