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Figure. Main results of the study{BR}(A) Proportion of responders during 4 weeks.{BR}† Proportion of responders: proportion of patients who showed adequate relief of overall epigastric pain or discomfort more than four times out of eight during 4 weeks of therapeutic period. *** P < 0.001 vs. waitlist control group analyzed by Fisher's exact test.{BR}(B) Total score of NDI questionnaire.{BR}NDI-K: Nepean dyspepsia index Korean version, * P < 0.05 vs. waitlist control group analyzed by Mann-Whitney U test, *** P < 0.001 vs. baseline analyzed by Wilcoxon signed rank test.{BR}(C) The scores of FDQoL.{BR}FD-QOL: Functional dyspepsia quality of life, *** P < 0.001 vs. baseline analyzed by Wilcoxon signed rank test.

Background & Aims: Little is known about the long-term effects of interferon α on clinical outcome and survival of patients with chronic hepatitis D. Methods: Thirty-six patients with chronic hepatitis D who participated in a randomized controlled trial of a 48-week course of high (9 million units) or low (3 million units) doses of interferon α or no treatment were followed for an additional 2 to 14 years. Results: Long-term survival was significantly longer in the high-dose group than in untreated controls ( P = 0.003) or in the low-dose group ( P = 0.019) but did not differ between patients treated with 3 million units and controls. Among surviving patients at 12 years of follow-up, a biochemical response was present in 7 of 12 treated with 9 million units, in 2 of 4 who received 3 million units, and in none of 3 controls. Long-term alanine aminotransferase (ALT) normalization correlated with improved hepatic function and loss of IgM antibody to hepatitis delta antigen (anti-HD). Patients in the high-dose group had a sustained decrease in HDV replication ( P = 0.008), leading to clearance of HDV RNA and, eventually, hepatitis B virus (HBV) in some patients, as well as a dramatic improvement in liver histology with respect to activity grade ( P = 0.0004) and fibrosis stage ( P = 0.007). Strikingly, we documented an absence of fibrosis in the final biopsy of 4 patients with a long-term biochemical response and an initial diagnosis of active cirrhosis. Conclusions: High doses of interferon α-2a significantly improved the long-term clinical outcome and survival of patients with chronic hepatitis D, even though the majority had active cirrhosis before the onset of therapy.

was categorized as "negative" or "positive" or "eradicated". The study patients were categorized according to the presence of inlet patch as follows: group A, inlet patch positive; group B, inlet patch negative. Intergroup male-to-female ratios, H. pylori infection rate, and the prevalence of gastrointestinal diseases were compared using the Chi square test. Result: The baseline clinical characteristics are shown in Table 1. A total of 487 patients (237 females and 250 males, mean age 53.7 years) were examined. Of these, 47 patients (9.4%) were inlet patch positive (Group A), and 440 patients were inlet patch negative (Group B). The male-to-female ratio was significantly higher in group A than group B. Mean age was not statistically different in group A and group B. The prevalence of gastric atrophy, reflux esophagitis, esophageal hiatal hernia, and Barrett's esophagus were not different in group A and group B. The 47 inlet patches were pathologically examined, and the histological features were inactive atrophic fundic mucosa with mild to moderate mucus neck cell or pyloric gland cell metaplasia and no intestinal metaplasia except one case with H. pylori infection. Conclusion: Endoscopic detection rate of inlet patch was 9.4%. Male gender was risk factor for inlet patch. Pathological characteristics of inlet patch was mostly inactive fundic gastritis with (pseudo) pyloric gland metaplasia.

was categorized as "negative" or "positive" or "eradicated". The study patients were categorized according to the presence of inlet patch as follows: group A, inlet patch positive; group B, inlet patch negative. Intergroup male-to-female ratios, H. pylori infection rate, and the prevalence of gastrointestinal diseases were compared using the Chi square test. Result: The baseline clinical characteristics are shown in Table 1. A total of 487 patients (237 females and 250 males, mean age 53.7 years) were examined. Of these, 47 patients (9.4%) were inlet patch positive (Group A), and 440 patients were inlet patch negative (Group B). The male-to-female ratio was significantly higher in group A than group B. Mean age was not statistically different in group A and group B. The prevalence of gastric atrophy, reflux esophagitis, esophageal hiatal hernia, and Barrett's esophagus were not different in group A and group B. The 47 inlet patches were pathologically examined, and the histological features were inactive atrophic fundic mucosa with mild to moderate mucus neck cell or pyloric gland cell metaplasia and no intestinal metaplasia except one case with H. pylori infection. Conclusion: Endoscopic detection rate of inlet patch was 9.4%. Male gender was risk factor for inlet patch. Pathological characteristics of inlet patch was mostly inactive fundic gastritis with (pseudo) pyloric gland metaplasia.