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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.


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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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