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1. Ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin for patients with hepatitis C virus genotype 1 or 4 infection with cirrhosis (ABACUS): a prospective observational study

Author

Petta, Salvatore, Marzioni, Marco, Russo, Pierluigi, Aghemo, Alessio, Alberti, Alfredo, ASCIONE, ANTONIO, Antinori, Andrea, Bruno, Raffaele, Bruno, Savino, Chirianni, Antonio, Gaeta, Giovanni Battista, Giannini, Edoardo G, Merli, Manuela, Messina, Vincenzo, Montilla, Simona, Perno, Carlo Federico, Puoti, Massimo, Raimondo, Giovanni, Rendina, Maria, Silberstein, Francesca Ceccherini, Villa, Erica, Zignego, Anna Linda, Pani, Luca, Craxì, Antonio, Tabone, Marco, Andreoni, Massimo, Teti, Elisabetta, Angelico, Mario, Persico, Marcello, Masarone, Mario, Chiodera, Aledssandro, Solinas, Attilio, delle Monache, Marco, Cecere, Roberto, Maria Schimizzi, Anna, Piovesan, Sara, Campagnolo, Davide, Chiara Piras, Maria, Zolfino, Teresa, Paolo Russo, Francesca, Morelli, Olivia, Sangiovanni, Vincenzo, Onofrio, Mirella, Iodice, Valentina, Izzi, Antonio, Pirisi, Massimo, Danieli, Elena, Vinci, Maria, Rizzardini, Giuliano, Fagiuoli, Stefano, Pasulo, Luisa, D'Arminio Monforte, Antonella, Zuin, Massimo, Giorgini, Alessia, Simeone, Filomena, Piali, Guido, Lo Guercio, Carmela, Federico, Alessandro, Brancaccio, Giuseppina, Marrone, Aldo, Abbati, Giuseppe, Boarini, Chiara, Borghi, Vanni, Bernabucci, Veronica, Corti, Giampaolo, Monti, Monica, Rizzetto, Mario, Martini, Silvia, Andreone, Pietro, Gianstefani, Alice, Lenzi, Marco, Verucchi, Gabriella, Toniutto, Pierluigi, Borgia, Guglielmo, Caporaso, Nicola, Morisco, Filomena, Nardone, Gaetano, Angrisani, Debora, Giacometti, Andrea, Benedetti, Antonio, Tarantino, Giuseppe, Marsetti, Fabio, Tavio, Marcello, Novara, Sergio, Antonia Santantonio, Teresa, Serviddio, Gaetano, Brunetto, Maurizia, Coco, Barbara, Angarano, Gioacchino, Milella, Michele, BARONE, MICHELE, Di Leo, Alfredo, Ettore Sansonno, Domenico, Cacciola, Irene, Boffa, Nicola, Saracco, Giorgio, Di Biagio, Antonio, Picciotto, Antonino, de Luca, Andrea, Calvaruso, Vincenza, Corradori, Silvia, Ferrari, Carlo, Orlandini, Alessandra, Maida, Ivana, Torti, Carlo, Chessa, Luchino, Felder, Martina, Vespasiani Gentilucci, Umberto, Angeli, Paolo, Romano, Antonietta, Ludovico Rapaccini, Gian, Miele, Luca, Cima, Serena, Luisa Russo, Maria, Cozzolongo, Raffaele, Onnelli, Giovanna, D'Offizi, Giampiero, Lionetti, Raffaella, Montalbano, Marzia, Guerra, Michele, Di Perri, Giovanni, Boglione, Lucio, Capra, Franco, Carolo, Giada, Ieluzzi, Donatella, Antonini, Cinzia, Termite, Antonio, Madonia, Salvatore, Tarquini, Pierluigi, Parruti, Giustino, Vecchiet, Giacomo, Falasca, Katia, Menzaghi, Barbara, Quirino, Tiziana, Dentone, Chiara, Maria Piscaglia, Anna, Rossi, Cristina, Giordani, Maria, Fontanella, Luca, Cassola, Giovanni, Russello, Maurizio, Cristaudo, Antonio, Giacomet, Vania, Colombo, Massimo, Donato, Francesca, Durante, Emanuele, Cosco, Lucio, Marignani, Massimo, Quartini, Mariano, Memoli, Massimo, Ganga, Roberto, Ponti, Laura, Soria, Alessandro, Grazia Rumi, Maria, Gulminetti, Roberto, Maserati, Renato, Mondelli, Mario, Lazzarin, Adriano, Rita Parisi, Maria, Canovari, Benedetta, Avancini, Ivo, Pravadelli, Cecilia, Blanc, Pier, Pasquazzi, Caterina, Maria Mastroianni, Claudio, Lichtner, Myriam, Distefano, Marco, Magnani, Silvia, Paganin, Simona, Erne, Elke, Gatti, Pietro, Tundi, Paolo, Calabrese, Paolo, Gasbarrini, Antonio, Grieco, Antonio, Coppola, Nicola, Del Poggio, Paolo, Levrero, Massimo, Talliani, Gloria, Vullo, Vincenzo, Cauda, Roberto, La Monica, Silvia, Potenza, Domenico, Rizzo, Salvatore, Castelli, Francesco, Marie Pigozzi, Grazielle, Ciancio, Alessia, Romagnoli, Dante, Barchetti, Federica, Ivanovic, Jelena, Longo, Olimpia, Petraglia, Sandra, Paola Trotta, Maria, NARDONE, GERARDO ANTONIO PIO, Petta, Salvatore, Marzioni, Marco, Russo, Pierluigi, Aghemo, Alessio, Alberti, Alfredo, Ascione, Antonio, Antinori, Andrea, Bruno, Raffaele, Bruno, Savino, Chirianni, Antonio, Gaeta, Giovanni Battista, Giannini, Edoardo G, Merli, Manuela, Messina, Vincenzo, Montilla, Simona, Perno, Carlo Federico, Puoti, Massimo, Raimondo, Giovanni, Rendina, Maria, Silberstein, Francesca Ceccherini, Villa, Erica, Zignego, Anna Linda, Pani, Luca, Craxì, Antonio, Tabone, Marco, Andreoni, Massimo, Teti, Elisabetta, Angelico, Mario, Persico, Marcello, Masarone, Mario, Chiodera, Aledssandro, Solinas, Attilio, delle Monache, Marco, Cecere, Roberto, Maria Schimizzi, Anna, Piovesan, Sara, Campagnolo, Davide, Chiara Piras, Maria, Zolfino, Teresa, Paolo Russo, Francesca, Morelli, Olivia, Sangiovanni, Vincenzo, Onofrio, Mirella, Iodice, Valentina, Izzi, Antonio, Pirisi, Massimo, Danieli, Elena, Vinci, Maria, Rizzardini, Giuliano, Fagiuoli, Stefano, Pasulo, Luisa, D'Arminio Monforte, Antonella, Zuin, Massimo, Giorgini, Alessia, Simeone, Filomena, Piali, Guido, Lo Guercio, Carmela, Federico, Alessandro, Brancaccio, Giuseppina, Marrone, Aldo, Abbati, Giuseppe, Boarini, Chiara, Borghi, Vanni, Bernabucci, Veronica, Corti, Giampaolo, Monti, Monica, Rizzetto, Mario, Martini, Silvia, Andreone, Pietro, Gianstefani, Alice, Lenzi, Marco, Verucchi, Gabriella, Toniutto, Pierluigi, Borgia, Guglielmo, Caporaso, Nicola, Morisco, Filomena, Nardone, Gaetano, Angrisani, Debora, Giacometti, Andrea, Benedetti, Antonio, Tarantino, Giuseppe, Marsetti, Fabio, Tavio, Marcello, Novara, Sergio, Antonia Santantonio, Teresa, Serviddio, Gaetano, Brunetto, Maurizia, Coco, Barbara, Angarano, Gioacchino, Milella, Michele, Barone, Michele, Di Leo, Alfredo, Ettore Sansonno, Domenico, Cacciola, Irene, Boffa, Nicola, Saracco, Giorgio, Di Biagio, Antonio, Picciotto, Antonino, de Luca, Andrea, Calvaruso, Vincenza, Corradori, Silvia, Ferrari, Carlo, Orlandini, Alessandra, Maida, Ivana, Torti, Carlo, Chessa, Luchino, Felder, Martina, Vespasiani Gentilucci, Umberto, Angeli, Paolo, Romano, Antonietta, Ludovico Rapaccini, Gian, Miele, Luca, Cima, Serena, Luisa Russo, Maria, Cozzolongo, Raffaele, Onnelli, Giovanna, D'Offizi, Giampiero, Lionetti, Raffaella, Montalbano, Marzia, Guerra, Michele, Di Perri, Giovanni, Boglione, Lucio, Capra, Franco, Carolo, Giada, Ieluzzi, Donatella, Antonini, Cinzia, Termite, Antonio, Madonia, Salvatore, Tarquini, Pierluigi, Parruti, Giustino, Vecchiet, Giacomo, Falasca, Katia, Menzaghi, Barbara, Quirino, Tiziana, Dentone, Chiara, Maria Piscaglia, Anna, Rossi, Cristina, Giordani, Maria, Fontanella, Luca, Cassola, Giovanni, Russello, Maurizio, Cristaudo, Antonio, Giacomet, Vania, Colombo, Massimo, Donato, Francesca, Durante, Emanuele, Cosco, Lucio, Marignani, Massimo, Quartini, Mariano, Memoli, Massimo, Ganga, Roberto, Ponti, Laura, Soria, Alessandro, Grazia Rumi, Maria, Gulminetti, Roberto, Maserati, Renato, Mondelli, Mario, Lazzarin, Adriano, Rita Parisi, Maria, Canovari, Benedetta, Avancini, Ivo, Pravadelli, Cecilia, Blanc, Pier, Pasquazzi, Caterina, Maria Mastroianni, Claudio, Lichtner, Myriam, Distefano, Marco, Magnani, Silvia, Paganin, Simona, Erne, Elke, Gatti, Pietro, Tundi, Paolo, Calabrese, Paolo, Gasbarrini, Antonio, Grieco, Antonio, Coppola, Nicola, Del Poggio, Paolo, Levrero, Massimo, Talliani, Gloria, Vullo, Vincenzo, Cauda, Roberto, La Monica, Silvia, Potenza, Domenico, Rizzo, Salvatore, Castelli, Francesco, Marie Pigozzi, Grazielle, Ciancio, Alessia, Romagnoli, Dante, Barchetti, Federica, Ivanovic, Jelena, Longo, Olimpia, Petraglia, Sandra, Paola Trotta, Maria, Petta, S., Marzioni, M., Russo, P., Aghemo, A., Alberti, A., Ascione, A., Antinori, A., Bruno, R., Bruno, S., Chirianni, A., Gaeta, G., Giannini, E., Merli, M., Messina, V., Montilla, S., Perno, C., Puoti, M., Raimondo, G., Rendina, M., Silberstein, F., Villa, E., Zignego, A., Pani, L., Craxi, A., Tabone, M., Andreoni, M., Teti, E., Angelico, M., Persico, M., Masarone, M., Chiodera, A., Solinas, A., delle Monache, M., Cecere, R., Maria Schimizzi, A., Piovesan, S., Campagnolo, D., Chiara Piras, M., Zolfino, T., Paolo Russo, F., Morelli, O., Sangiovanni, V., Onofrio, M., Iodice, V., Izzi, A., Pirisi, M., Danieli, E., Vinci, M., Rizzardini, G., Fagiuoli, S., Pasulo, L., D'Arminio Monforte, A., Zuin, M., Giorgini, A., Simeone, F., Piali, G., Lo Guercio, C., Federico, A., Brancaccio, G., Marrone, A., Abbati, G., Boarini, C., Borghi, V., Bernabucci, V., Corti, G., Monti, M., Rizzetto, M., Martini, S., Andreone, P., Gianstefani, A., Lenzi, M., Verucchi, G., Toniutto, P., Borgia, G., Caporaso, N., Morisco, F., Nardone, G., Angrisani, D., Giacometti, A., Benedetti, A., Tarantino, G., Marsetti, F., Tavio, M., Novara, S., Antonia Santantonio, T., Serviddio, G., Brunetto, M., Coco, B., Angarano, G., Milella, M., Barone, M., Di Leo, A., Ettore Sansonno, D., Cacciola, I., Boffa, N., Saracco, G., Di Biagio, A., Picciotto, A., de Luca, A., Calvaruso, V., Corradori, S., Ferrari, C., Orlandini, A., Maida, I., Torti, C., Chessa, L., Felder, M., Vespasiani Gentilucci, U., Angeli, P., Romano, A., Ludovico Rapaccini, G., Miele, L., Cima, S., Luisa Russo, M., Cozzolongo, R., Onnelli, G., D'Offizi, G., Lionetti, R., Montalbano, M., Guerra, M., Di Perri, G., Boglione, L., Capra, F., Carolo, G., Ieluzzi, D., Antonini, C., Termite, A., Madonia, S., Tarquini, P., Parruti, G., Vecchiet, G., Falasca, K., Menzaghi, B., Quirino, T., Dentone, C., Maria Piscaglia, A., Rossi, C., Giordani, M., Fontanella, L., Cassola, G., Russello, M., Cristaudo, A., Giacomet, V., Colombo, M., Donato, F., Durante, E., Cosco, L., Marignani, M., Quartini, M., Memoli, M., Ganga, R., Ponti, L., Soria, A., Grazia Rumi, M., Gulminetti, R., Maserati, R., Mondelli, M., Lazzarin, A., Rita Parisi, M., Canovari, B., Avancini, I., Pravadelli, C., Blanc, P., Pasquazzi, C., Maria Mastroianni, C., Lichtner, M., Distefano, M., Magnani, S., Paganin, S., Erne, E., Gatti, P., Tundi, P., Calabrese, P., Gasbarrini, A., Grieco, A., Coppola, N., Del Poggio, P., Levrero, M., Talliani, G., Vullo, V., Cauda, R., La Monica, S., Potenza, D., Rizzo, S., Castelli, F., Marie Pigozzi, G., Ciancio, A., Romagnoli, D., Barchetti, F., Ivanovic, J., Longo, O., Petraglia, S., Paola Trotta, M., Savino, Bruno, Nardone, GERARDO ANTONIO PIO, Petta, S, Marzioni, M, Russo, P, Aghemo, A, Alberti, A, Ascione, A, Antinori, A, Bruno, R, Bruno, S, Chirianni, A, Gaeta, G, Giannini, E, Merli, M, Messina, V, Montilla, S, Perno, C, Puoti, M, Raimondo, G, Rendina, M, Silberstein, F, Villa, E, Zignego, A, Pani, L, Craxì, A, and Fagiuoli, S

Subjects
Cyclopropanes, Compassionate Use Trials, Liver Cirrhosis, Male, chemistry.chemical_compound, 0302 clinical medicine, 2-Naphthylamine, HCV, direct-acting antiviral, mixed cryoglobulinemia, RBV, Anilides, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Chronic, Adult, Aged, Antiviral Agents, Carbamates, Drug Therapy, Combination, Female, Genotype, Hepatitis C, Chronic, Humans, Macrocyclic Compounds, Middle Aged, Ribavirin, Ritonavir, Sulfonamides, Treatment Outcome, Uracil, Settore MED/12 - Gastroenterologia, Dasabuvir, HCV DAA, Gastroenterology, virus diseases, Valine, Settore MED/07 - Microbiologia e Microbiologia Clinica, Hepatitis C, Hepatology, Combination, 030211 gastroenterology & hepatology, medicine.drug, medicine.medical_specialty, Proline, Lactams, Macrocyclic, Hepatitis C virus genotype 1, Hepatitis C virus genotype 4, decompensated liver cirrhosis, antiviral therapy, dasabuvir, ombitasvir, paritaprevir, 03 medical and health sciences, Drug Therapy, Internal medicine, medicine, Decompensation, Adverse effect, business.industry, Virology, Ombitasvir, Clinical trial, chemistry, Paritaprevir, business
Abstract

Summary Background We ran a compassionate use nationwide programme (ABACUS) to provide access to ombitasvir, paritaprevir, and ritonavir, with dasabuvir, plus ribavirin for hepatitis C virus (HCV) genotype 1 infection and ombitasvir, paritaprevir, and ritonavir, plus ribavirin for HCV genotype 4 infection in patients with cirrhosis at high risk of decompensation while approval of these regimens was pending in Italy. Methods In this prospective observational study, we collected data from a compassionate use nationwide programme from March 17, 2014, to May 28, 2015. Patients with HCV genotype 1 infection and cirrhosis at high risk of decompensation were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once daily and dasabuvir (250 mg) twice daily for 12 weeks (patients with HCV genotype 1b infection) or 24 weeks (patients with HCV genotype 1a infection). Patients with HCV genotype 4 infection were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once per day for 24 weeks. All patients were given weight-based ribavirin. The primary efficacy endpoint was sustained virological response at week 12 after the end of treatment (SVR12), analysed by intention-to-treat. Univariate and multivariate logistic regression analyses were used to identify baseline characteristics associated with SVR12. Adverse events were recorded throughout the study. Findings 728 (96%) of 762 patients with cirrhosis who were given ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin therapy for 12 or 24 weeks achieved SVR12. Logistic regression analyses identified that bilirubin concentrations of less than 2 mg/dL were associated with SVR12 (odds ratio [OR] 4·76 [95% CI 1·83–12·3]; p=0·001). 166 (23%) of 734 patients included in safety analyses had an adverse event. 25 (3%) patients discontinued treatment because of adverse events. Asthenia was the most commonly reported adverse event, occurring in 36 (5%) patients. Interpretation Our findings suggest that the safety and effectiveness of ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin in patients with HCV genotype 1 or 4 infection and cirrhosis at high risk of decompensation in a real-life setting are similar to those reported in clinical trials. The concordance with clinical trials provides reassurance that the reported efficacy of this treatment in clinical trials will translate to its use in routine clinical practice. Funding Dipartimento Biomedico di Medicina Interna e Specialistica dell'Universita di Palermo.

Published
2017

2. Long term follow-up and outcome of liver transplantation for alcoholic liver disease: a single center case-control study

Author

BISELLI, MAURIZIO, GRAMENZI, ANNAGIULIA, DEL GAUDIO, MASSIMO, RAVAIOLI, MATTEO, VITALE, GIOVANNI, GITTO, STEFANO, GRAZI, GIAN LUCA, PINNA, ANTONIO DANIELE, ANDREONE, PIETRO, BERNARDI, MAURO, Bologna Liver Transplantation Group, BIANCHI, FRANCESCO BIANCO, BOLONDI, LUIGI, CESCON, MATTEO, D'ERRICO, ANTONIETTA, ERCOLANI, GIORGIO, GRIGIONI, FRANCO, LENZI, MARCO, LODATO, FRANCESCA, MAZZELLA, GIUSEPPE, PISCAGLIA, FABIO, RODA, ENRICO, SAMA, CLAUDIA, TAME', MARIAROSA, Biselli M, Gramenzi A, Del Gaudio M, Ravaioli M, Vitale G, Gitto S, Grazi GL, Pinna AD, Andreone P, Bernardi M, and and Bologna Liver Transplantation Group.

Subjects
Adult, Graft Rejection, Male, Reoperation, medicine.medical_specialty, Alcoholic liver disease, Cirrhosis, medicine.medical_treatment, Alcoholic hepatitis, Liver transplantation, CHRONIC HEPATITIS C, LONG-TERM OUTCOME, Single Center, Gastroenterology, Postoperative Complications, Liver Cirrhosis, Alcoholic, Recurrence, Internal medicine, medicine, Humans, ALCOHOLIC LIVER CIRRHOSIS, LIVER TRANSPLANTATION, business.industry, Graft Survival, Case-control study, Odds ratio, Middle Aged, medicine.disease, Hepatitis C, Confidence interval, Survival Rate, Alcoholism, Treatment Outcome, surgical procedures, operative, Case-Control Studies, Multivariate Analysis, Female, business, Follow-Up Studies
Abstract

Background: Alcoholic liver cirrhosis (ALC) is a leading indication for orthotopic liver transplantation (OLT). Goals: To investigate the long-term outcome of OLT for ALC compared with patients transplanted for hepatitis C virus (HCV) infection. Study: From 1987 to 2001, 49 OLT were performed for ALC and 173 for HCV. From these contemporary groups we matched 1:2 ALC patients (cases) to 98 HCV (controls). The following variables were analyzed: survival, retransplantation, rejection, primary nonfunction, infections, de novo tumors, cardiovascular and neurologic complications, and alcoholic recurrence. Results: Actuarial survival rate at 9 years was comparable for cases and controls. Actuarial graft survival rate at 9 years was significantly higher in cases (78% vs. 60%; P = 0.026). The retransplantation rate was higher in controls (21 % vs. 4%; P = 0.007). Post-OLT complications were not significantly different. The alcoholic recidivism rate was 28% without influence on patients or graft survival, whereas relapse of HCV caused the majority of death in controls (30%; P = 0.042). At multivariate analysis retransplantation was the only predictor of patient survival (odds ratio: 4.35; 95% confidence interval: 2.16-8.74; P < 0.001), whereas HCV was associated with a 2-fold probability of graft failure (odds ratio: 1.97; 95% confidence interval: 1.02-3.81; P = 0.032). Conclusions: The long-term outcome of OLT for ALC is comparable to that for HCV, even if graft survival is significantly better among ALC. These data support ALC as an excellent indication for OLT.

Published
2010

3. Standardization of Autoantibody Testing in Autoimmune Hepatitis

Author

Luigi Muratori, Marco Lenzi, Paolo Muratori, Muratori, Paolo, Lenzi, Marco, and Muratori, Luigi

Subjects
Allergy, business.industry, Autoantibody, Autoimmunity, General Medicine, Autoimmune hepatitis, Autoimmune hepatiti, medicine.disease, Autoantibodie, Hepatitis, Autoimmune, Anti-smooth muscle antibodie, Immunology, Humans, Medicine, Immunology and Allergy, Disease Susceptibility, Anti-actin, business, Autoantibodies
Abstract

It is a comment on a recent review published on the Journal.

Published
2020

4. Clinical implications of antimitochondrial antibody seropositivity in autoimmune hepatitis

Author

Alexandra Heurgué-Berlot, Ersan Ozaslan, Staffan Wahlin, Marco Lenzi, Thomas D. Schiano, Luigi Muratori, Claudine Lalanne, Cumali Efe, Paolo Muratori, Eric M. Yoshida, Muratori, Paolo, Efe, Cumali, Muratori, Luigi, Ozaslan, Ersan, Schiano, Thoma, Yoshida, Eric M., Heurgué-Berlot, Alexandra, Lalanne, Claudine, Lenzi, Marco, and Wahlin, Staffan

Subjects
Male, 0301 basic medicine, Cholangitis, medicine.medical_treatment, Autoimmune hepatitis, medicine.disease_cause, Gastroenterology, Serology, Autoimmunity, primary biliary cirrhosi, 0302 clinical medicine, immune system diseases, Child, autoimmune hepatiti, Aged, 80 and over, Univariate analysis, Immunosuppression, Middle Aged, autoantibodie, Mitochondria, Europe, Hepatitis, Autoimmune, Treatment Outcome, Child, Preschool, antimitochondrial antibodie, Antimitochondrial antibody, Female, 030211 gastroenterology & hepatology, Immunosuppressive Agents, Adult, medicine.medical_specialty, Adolescent, Young Adult, 03 medical and health sciences, Internal medicine, parasitic diseases, medicine, Humans, Serologic Tests, Clinical significance, Aged, Autoantibodies, Chi-Square Distribution, Hepatology, business.industry, Autoantibody, medicine.disease, digestive system diseases, Logistic Models, 030104 developmental biology, Case-Control Studies, North America, Immunology, business, Biomarkers
Abstract

Background/aim Antimitochondrial antibody (AMA) positivity is the serological marker of primary biliary cholangitis (PBC), but can also be sporadically detected in autoimmune hepatitis (AIH). Little is known about the clinical significance of AMA in AIH. Patients and methods We recruited 47 AMA-positive AIH cases from several centres and compared them with 264 well-characterized Italian AIH patients. Cases with any features of PBC were excluded. Results In univariate analysis, AMA-positive AIH patients were older (46 vs. 36, P=0.002) and more responsive to immunosuppression (74 vs. 59%, P=0.05), but no differences were observed between the two groups after logistic regression using AMA as a dependent variable. None of the AMA-positive AIH patients showed signs of evolving PBC features after a median follow-up of up 47 months. AMA was detected in combination with all serological AIH markers except antiliver kidney microsome type 1 and antiliver cytosol type 1. AMA was the only marker of autoimmunity in eight cases. Conclusion We found no differences between AIH with and without AMA. The groups had similar clinical, biochemical and histological features. AMA-positive AIH patients did not evolve towards PBC. In some cases, AMA was the only autoantibody.

Published
2017

5. Diagnosis of primary biliary cholangitis in a 'teen' male patient

Author

Marco Lenzi, Luigi Muratori, Paolo Muratori, Muratori, Paolo, Lenzi, Marco, and Muratori, Luigi

Subjects
Pediatrics, medicine.medical_specialty, Primary (chemistry), Text mining, Hepatology, Male patient, business.industry, Gastroenterology, medicine, Primary biliary cholangitis, autoimmunity, medicine.disease_cause, business, Autoimmunity
Abstract

not available

Published
2019

6. Predictive factors of poor response to therapy in Autoimmune Hepatitis

Author

Luigi Muratori, Giampaolo Bianchi, Claudine Lalanne, Paolo Muratori, Marco Lenzi, Muratori, Paolo, Lalanne, Claudine, Bianchi, Giampaolo, Lenzi, Marco, and Muratori, Luigi

Subjects
Liver Cirrhosis, Male, Cirrhosis, Databases, Factual, Drug Resistance, Azathioprine, Autoimmune hepatitis, Antibodies, Viral, Gastroenterology, 0302 clinical medicine, Liver Function Tests, Adrenal Cortex Hormones, Young adult, Child, Aged, 80 and over, biology, medicine.diagnostic_test, Medicine (all), Age Factors, Alanine Transaminase, Middle Aged, Prognosis, Hepatitis, Autoimmune, Treatment Outcome, Italy, Liver, Autoimmune liver disease, Child, Preschool, Liver function test, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Immunology, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Aspartate Aminotransferases, Aged, Cirrhosi, Hepatology, business.industry, Stepwise regression, medicine.disease, Logistic Models, Alanine transaminase, Immunoglobulin G, biology.protein, business, Liver function tests
Abstract

Aim To evaluate “ex ante” the predictive factors of incomplete/absent response to the standard therapy in a well characterized series of Autoimmune Hepatitis (AIH) patients from Italy. Methods Of 282 AIH patients screened from our database 166 (59%) had a sustained response and 116 (41%) had an incomplete/absent response to the therapy; all patients were analyzed for the clinical, serological and histological parameters at diagnosis. Results The patients with incomplete/absent response were characterized by significantly younger age (30 aa vs 42 aa p = 0.001) and a significantly higher frequency of cirrhosis at diagnosis than patients who had a complete response to therapy (26% vs 3% p

Published
2016

7. Immune inflammation indicators and ALBI score to predict liver cancer in HCV-patients treated with direct-acting antivirals

Author

Stefano Gitto, Giuseppe Mazzella, Luigi Bolondi, Francesco Giuseppe Foschi, Federica Buonfiglioli, Elisabetta Petracci, Andrea Casadei Gardini, Stefano Brillanti, Pietro Andreone, Federico Ravaioli, Ranka Vukotic, Fabio Conti, Giovanni Vitale, Marco Lenzi, Gabriella Verucchi, Giorgia Marisi, Casadei Gardini, Andrea, Foschi, Francesco Giuseppe, Conti, Fabio, Petracci, Elisabetta, Vukotic, Ranka, Marisi, Giorgia, Buonfiglioli, Federica, Vitale, Giovanni, Ravaioli, Federico, Gitto, Stefano, Verucchi, Gabriella, Lenzi, Marco, Bolondi, Luigi, Mazzella, Giuseppe, Brillanti, Stefano, and Andreone, Pietro

Subjects
Liver Cirrhosis, Male, Cirrhosis, Multivariate analysis, Kaplan-Meier Estimate, Gastroenterology, 0302 clinical medicine, Risk Factors, Albumin, ALRI, Bilirubin, Cancer immunosurveillance, Interferon-free therapy, NLR, PLR, SII, Hepatology, Aged, 80 and over, Univariate analysis, Liver Neoplasms, Middle Aged, Prognosis, Italy, Liver, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Female, Liver cancer, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Antiviral Agents, Risk Assessment, 03 medical and health sciences, Internal medicine, medicine, Biomarkers, Tumor, Humans, Aspartate Aminotransferases, Lymphocyte Count, Neutrophil to lymphocyte ratio, Serum Albumin, Aged, Proportional Hazards Models, Retrospective Studies, Cirrhosi, business.industry, Platelet Count, Retrospective cohort study, Hepatitis C, Chronic, medicine.disease, digestive system diseases, Multivariate Analysis, Neoplasm Recurrence, Local, business
Abstract

Background Unexpectedly high occurrence or recurrence rate of hepatocellular carcinoma (HCC) has been observed in patients with chronic hepatitis C receiving direct-acting antivirals (DAAs) therapy. Aims We evaluated the predictive value of albumin-bilirubin (ALBI) score and immune-inflammation indicators to identify the risk of occurrence or recurrence of HCC in patients treated with DAAs in a real life setting. Methods In this retrospective cohort study, we analysed data from 514 patients with cirrhosis who were prospectively enrolled for treatment with DAAs. We assessed baseline neutrophil to lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR), aspartate aminotransferase-lymphocyte ratio (ALRI) index and ALBI score. Results In patients with no history of HCC (N = 416), increased AST, bilirubin, ALRI, and ALBI score, and decreased albumin and platelets were significantly associated with an increased risk of HCC development, at univariate analysis. At multivariate analysis, increase in ALBI grade (p = 0.038, HR: 2.35, 95% CI: 1.05–5.25) and decrease in platelets (p = 0.048, HR: 0.92, 95% CI: 0.85–1.0) were independently associated with HCC development. In patients with previous HCC (N = 98), adjusting for the time from HCC treatment, increased ALRI (p = 0.008, HR: 1.05, 95% CI: 1.01–1.09) was significantly associated with a risk of recurrence. Conclusion ALBI score, platelet count and ALRI are promising, easy to perform and inexpensive tools for identifying patients with higher risk of HCC after treatment with DAAs.

Published
2018

8. The Role of Invariant NKT in Autoimmune Liver Disease: Can Vitamin D Act as an Immunomodulator?

Author

Giorgina Mieli-Vergani, Diego Vergani, Athanasios Mavropoulos, Marco Lenzi, Daniel S. Smyk, Dimitrios P. Bogdanos, Smyk, Daniel S., Mavropoulos, Athanasio, Mieli-Vergani, Giorgina, Vergani, Diego, Lenzi, Marco, and Bogdanos, Dimitrios P.

Subjects
0301 basic medicine, Cholangitis, Sclerosing, Receptors, Antigen, T-Cell, chemical and pharmacologic phenomena, Review Article, Stem cell marker, T-Lymphocytes, Regulatory, Proinflammatory cytokine, 03 medical and health sciences, 0302 clinical medicine, Immune system, Antigen, medicine, Animals, Humans, lcsh:RC799-869, Vitamin D, B cell, B-Lymphocytes, biology, Hepatology, business.industry, Liver Cirrhosis, Biliary, Myeloid-Derived Suppressor Cells, T-cell receptor, Gastroenterology, General Medicine, Natural killer T cell, Immunity, Innate, Hepatitis, Autoimmune, 030104 developmental biology, medicine.anatomical_structure, CD1D, Immunology, biology.protein, Natural Killer T-Cells, lcsh:Diseases of the digestive system. Gastroenterology, business, 030215 immunology
Abstract

Natural killer T (NKT) cells are a distinct lineage of T cells which express both the T cell receptor (TCR) and natural killer (NK) cell markers. Invariant NKT (iNKT) cells bear an invariant TCR and recognize a small variety of glycolipid antigens presented by CD1d (nonclassical MHC-I). CD1d-restricted iNKT cells are regulators of immune responses and produce cytokines that may be proinflammatory (such as interferon-gamma (IFN-γ)) or anti-inflammatory (such as IL-4). iNKT cells also appear to play a role in B cell regulation and antibody production. Alpha-galactosylceramide (α-GalCer), a derivative of the marine sponge, is a potent stimulator of iNKT cells and has been proposed as a therapeutic iNKT cell activator. Invariant NKT cells have been implicated in the development and perpetuation of several autoimmune diseases such as multiple sclerosis and systemic lupus erythematosus (SLE). Animal models of SLE have shown abnormalities in iNKT cells numbers and function, and an inverse correlation between the frequency of NKT cells and IgG levels has also been observed. The role of iNKT cells in autoimmune liver disease (AiLD) has not been extensively studied. This review discusses the current data with regard to iNKT cells function in AiLD, in addition to providing an overview of iNKT cells function in other autoimmune conditions and animal models. We also discuss data regarding the immunomodulatory effects of vitamin D on iNKT cells, which may serve as a potential therapeutic target, given that deficiencies in vitamin D have been reported in various autoimmune disorders.

Published
2018

9. Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis

Author

Giada Carolo, Veronica Bernabucci, Luchino Chessa, Maria Luisa Russo, Giorgio Maria Saracco, Marzia Montalbano, Barbara Menzaghi, Giovanni Di Perri, Adriano Lazzarin, Silvia La Monica, Raffaele Bruno, Gian Ludovico Rapaccini, Mario U. Mondelli, Anna Maria Schimizzi, Caterina Pasquazzi, Maurizia Rossana Brunetto, Antonio Craxì, Filomena Morisco, Carmela Lo Guercio, Vania Giacomet, Alessia Giorgini, Mario Masarone, Francesca Paolo Russo, T. Zolfino, Vincenzo Sangiovanni, Alessia Ciancio, Antonella d'Arminio Monforte, Savino Bruno, E.M. Erne, Antonio Gasbarrini, Francesco Castelli, Sergio Novara, G. Nardone, Andrea De Luca, Claudio Maria Mastroianni, Gioacchino Angarano, Chiara Dentone, Renato Maserati, Anna Maria Piscaglia, Tiziana Quirino, Giuseppe Tarantino, M. Lichtner, Antonio Chirianni, Giuseppina Brancaccio, S. Paganin, Alfredo Alberti, Silvia Corradori, Edoardo G. Giannini, Carlo Torti, Chiara Boarini, Raffaele Cozzolongo, Marco Di Stefano, Alessandro Soria, Paolo Tundi, Giovanni Cassola, Debora Angrisani, Antonio Grieco, Cecilia Pravadelli, Giuliano Rizzardini, Roberto Gulminetti, Vincenzo Messina, Maria Rendina, Massimo Pirisi, Irene Cacciola, Roberto Ganga, Raffaella Lionetti, Paolo Calabrese, Laura Ponti, Filomena Simeone, Maurizio Russello, Monica Monti, Nicola Boffa, Pierluigi Tarquini, Franco Capra, Ivo Avancini, Domenico Sansonno, Stefano Fagiuoli, Michele Barone, Giacomo Vecchiet, Salvatore Rizzo, Carlo Federico Perno, Teresa Santantonio, Pierluigi Toniutto, Massimo Zuin, Nicola Caporaso, Alessandra Orlandini, Grazielle Marie Pigozzi, Martina Felder, Antonio Cristaudo, Roberto Cecere, Massimo Marignani, Vincenza Calvaruso, G. Abbati, Domenico Potenza, Maria Chiara Piras, Mario Rizzetto, Serena Cima, Marco delle Monache, Alessio Aghemo, D. Ieluzzi, Guglielmo Borgia, Giampaolo Corti, Paolo Poggio, Manuela Merli, Elena Danieli, Andrea Giacometti, Massimo Andreoni, Antonino Picciotto, Mario Angelico, Benedetta Canovari, Sara Piovesan, Anna Linda Zignego, Antonio Benedetti, Emanuele Durante, Erica Villa, Marcello Persico, Antonio Patrizio Termite, Barbara Coco, Maria Vinci, Lucio Boglione, Cristina Rossi, Paolo Angeli, Massimo Memoli, Maria Teresa Giordani, Massimo De Luca, Luisa Pasulo, Vincenzo Vullo, Mario Melazzini, Attilio Solinas, Pietro Gatti, Michele Guerra, Silvia Martini, Antonio Ascione, Massimo Puoti, Roberto Cauda, Giovanna Onnelli, Silvia Magnani, Salvatore Madonna, Giovanni Raimondo, Marco Tabone, Gloria Taliani, Dante Romagnoli, Aldo Marrone, Umberto Vespasiani Gentilucci, Luca Miele, Marcello Tavio, Andrea Antinori, Giampiero D'Offizi, Mirella Onofrio, Valentina Iodice, Lucio Cosco, Guido Piai, Luca Pani, Francesca Ceccherini Silberstein, Simona Montilla, Marco Lenzi, Luca Fontanella, Alessandro Federico, Carlo Ferrari, Giustino Parruti, Antonio Di Biagio, Gabriella Verucchi, Fabio Marsetti, Michele Milella, Maria Grazia Rumi, Antonio Izzi, Marco Marzioni, Francesca Donato, Vanni Borghi, Mariano Quartini, Massimo Colombo, Michele Imparato, Giovanni Battista Gaeta, P.L. Blanc, Alfredo Di Leo, Nicola Coppola, Alessandro Chiodera, Ivana Maida, Davide Campagnolo, Cinzia Antonini, Antonietta Romano, A. Gianstefani, Katia Falasca, Massimo Levrero, Gaetano Serviddio, Maria Paola Trotta, Olivia Morelli, Salvatore Petta, Elisabetta Teti, Maria Rita Parisi, Pietro Andreone, Ascione, Antonio, De Luca, Massimo, Melazzini, Mario, Montilla, Simona, Trotta, Maria Paola, Petta, Salvatore, Puoti, Massimo, Sangiovanni, Vincenzo, Messina, Vincenzo, Bruno, Savino, Izzi, Antonio, Villa, Erica, Aghemo, Alessio, Zignego, Anna Linda, Orlandini, Alessandra, Fontanella, Luca, Gasbarrini, Antonio, Marzioni, Marco, Giannini, Edoardo G., Craxì, Antonio, Abbati, Giuseppe, Alberti, Alfredo, Andreone, Pietro, Andreoni, Massimo, Angeli, Paolo, Angelico, Mario, Angarano, Gioacchino, Angrisani, Debora, Antinori, Andrea, Antonini, Cinzia, Avancini, Ivo, Barone, Michele, Bruno, Raffaele, Benedetti, Antonio, Bernabucci, Veronica, Blanc, Pier, Boarini, Chiara, Boffa, Nicola, Boglione, Lucio, Borghi, Vanni, Borgia, Guglielmo, Brancaccio, Giuseppina, Brunetto, Maurizia, Cacciola, Irene, Calabrese, Paolo, Calvaruso, Vincenza, Campagnolo, Davide, Canovari, Benedetta, Caporaso, Nicola, Capra, Franco, Carolo, Giada, Cassola, Giovanni, Castelli, Francesco, Cauda, Roberto, Silberstein, Francesca Ceccherini, Cecere, Roberto, Chessa, Luchino, Chiodera, Alessandro, Chirianni, Antonio, Ciancio, Alessia, Cima, Serena, Coco, Barbara, Colombo, Massimo, Coppola, Nicola, Corti, Giampaolo, Cosco, Lucio, Corradori, Silvia, Cozzolongo, Raffaele, Cristaudo, Antonio, Danieli, Elena, Monforte, Antonella D’Arminio, Monache, Marco delle, Del Poggio, Paolo, de Luca, Andrea, Dentone, Chiara, Di Biagio, Antonio, Di Leo, Alfredo, Di Perri, Giovanni, Di Stefano, Marco, D’Offizi, Giampiero, Donato, Francesca, Durante, Emanuele, Erne, Elke, Fagiuoli, Stefano, Falasca, Katia, Federico, Alessandro, Felder, Martina, Ferrari, Carlo, Gaeta, Giovanni Battista, Ganga, Roberto, Gatti, Pietro, Giacomet, Vania, Giacometti, Andrea, Gianstefani, Alice, Giordani, Maria, Giorgini, Alessia, Grieco, Antonio, Guerra, Michele, Gulminetti, Roberto, Ieluzzi, Donatella, Imparato, Michele, Iodice, Valentina, La Monica, Silvia, Lazzarin, Adriano, Lenzi, Marco, Levrero, Massimo, Lichtner, Myriam, Lionetti, Raffaella, Guercio, Carmela Lo, Madonna, Salvatore, Magnani, Silvia, Maida, Ivana, Marignani, Massimo, Marrone, Aldo, Marsetti, Fabio, Martini, Silvia, Masarone, Mario, Maserati, Renato, Mastroianni, Claudio Maria, Memoli, Massimo, Menzaghi, Barbara, Merli, Manuela, Miele, Luca, Milella, Michele, Mondelli, Mario, Montalbano, Marzia, Monti, Monica, Morelli, Olivia, Morisco, Filomena, Nardone, Gaetano, Novara, Sergio, Onnelli, Giovanna, Onofrio, Mirella, Paganin, Simona, Pani, Luca, Parisi, Maria Rita, Parruti, Giustino, Pasquazzi, Caterina, Pasulo, Luisa, Perno, Carlo Federico, Persico, Marcello, Piai, Guido, Picciotto, Antonino, Pigozzi, Grazielle Marie, Piovesan, Sara, Piras, Maria Chiara, Pirisi, Massimo, Piscaglia, Anna Maria, Ponti, Laura, Potenza, Domenico, Pravadelli, Cecilia, Quartini, Mariano, Quirino, Tiziana, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Rendina, Maria, Rizzardini, Giuliano, Rizzetto, Mario, Rizzo, Salvatore, Romagnoli, Dante, Romano, Antonietta, Rossi, Cristina, Rumi, Maria Grazia, Russello, Maurizio, Russo, Francesca Paolo, Russo, Maria Luisa, Sansonno, Domenico Ettore, Santantonio, Teresa Antonia, Saracco, Giorgio, Schimizzi, Anna Maria, Serviddio, Gaetano, Simeone, Filomena, Solinas, Attilio, Soria, Alessandro, Tabone, Marco, Taliani, Gloria, Tarantino, Giuseppe, Tarquini, Pierluigi, Tavio, Marcello, Termite, Antonio, Teti, Elisabetta, Toniutto, Pierluigi, Torti, Carlo, Tundi, Paolo, Vecchiet, Giacomo, Verucchi, Gabriella, Gentilucci, Umberto Vespasiani, Vinci, Maria, Vullo, Vincenzo, Zolfino, Teresa, Zuin, Massimo, Ascione, A, De Luca, M, Melazzini, M, Montilla, S, Trotta, M, Petta, S, Puoti, M, Sangiovanni, V, Messina, V, Bruno, S, Izzi, A, Villa, E, Aghemo, A, Zignego, A, Orlandini, A, Fontanella, L, Gasbarrini, A, Marzioni, M, Giannini, E, Craxi, A, Abbati, G, Alberti, A, Andreone, P, Andreoni, M, Angeli, P, Angelico, M, Angarano, G, Angrisani, D, Antinori, A, Antonini, C, Avancini, I, Barone, M, Bruno, R, Benedetti, A, Bernabucci, V, Blanc, P, Boarini, C, Boffa, N, Boglione, L, Borghi, V, Borgia, G, Brancaccio, G, Brunetto, M, Cacciola, I, Calabrese, P, Calvaruso, V, Campagnolo, D, Canovari, B, Caporaso, N, Capra, F, Carolo, G, Cassola, G, Castelli, F, Cauda, R, Silberstein, F, Cecere, R, Chessa, L, Chiodera, A, Chirianni, A, Ciancio, A, Cima, S, Coco, B, Colombo, M, Coppola, N, Corti, G, Cosco, L, Corradori, S, Cozzolongo, R, Cristaudo, A, Danieli, E, Monforte, A, Monache, M, Del Poggio, P, de Luca, A, Dentone, C, Di Biagio, A, Di Leo, A, Di Perri, G, Di Stefano, M, D'Offizi, G, Donato, F, Durante, E, Erne, E, Fagiuoli, S, Falasca, K, Federico, A, Felder, M, Ferrari, C, Gaeta, G, Ganga, R, Gatti, P, Giacomet, V, Giacometti, A, Gianstefani, A, Giordani, M, Giorgini, A, Grieco, A, Guerra, M, Gulminetti, R, Ieluzzi, D, Imparato, M, Iodice, V, La Monica, S, Lazzarin, A, Lenzi, M, Levrero, M, Lichtner, M, Lionetti, R, Guercio, C, Madonna, S, Magnani, S, Maida, I, Marignani, M, Marrone, A, Marsetti, F, Martini, S, Masarone, M, Maserati, R, Mastroianni, C, Memoli, M, Menzaghi, B, Merli, M, Miele, L, Milella, M, Mondelli, M, Montalbano, M, Monti, M, Morelli, O, Morisco, F, Nardone, G, Novara, S, Onnelli, G, Onofrio, M, Paganin, S, Pani, L, Parisi, M, Parruti, G, Pasquazzi, C, Pasulo, L, Perno, C, Persico, M, Piai, G, Picciotto, A, Pigozzi, G, Piovesan, S, Piras, M, Pirisi, M, Piscaglia, A, Ponti, L, Potenza, D, Pravadelli, C, Quartini, M, Quirino, T, Raimondo, G, Rapaccini, G, Rendina, M, Rizzardini, G, Rizzetto, M, Rizzo, S, Romagnoli, D, Romano, A, Rossi, C, Rumi, M, Russello, M, Russo, F, Russo, M, Sansonno, D, Santantonio, T, Saracco, G, Schimizzi, A, Serviddio, G, Simeone, F, Solinas, A, Soria, A, Tabone, M, Taliani, G, Tarantino, G, Tarquini, P, Tavio, M, Termite, A, Teti, E, Toniutto, P, Torti, C, Tundi, P, Vecchiet, G, Verucchi, G, Gentilucci, U, Vinci, M, Vullo, V, Zolfino, T, and Zuin, M

Subjects
Cyclopropanes, Liver Cirrhosis, Male, Cirrhosis, Dasabuvir, Elderly, Ombitasvir, Paritaprevir, Aged, 80 and over, Anilides, Antiviral Agents, Biomarkers, Carbamates, Female, Hepacivirus, Hepatitis C, Chronic, Humans, Macrocyclic Compounds, Ribavirin, Ritonavir, Sulfonamides, Treatment Outcome, Uracil, Drug Therapy, Combination, Genotype, Cirrhosis, Dasabuvir, Elderly, Ombitasvir, Paritaprevir, Microbiology (medical), Infectious Diseases, Aged, 80 and over, Hepatitis C, Chronic, Drug Therapy, Combination, Microbiology (medical), Infectious Diseases, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, 2-Naphthylamine, Medicine, 030212 general & internal medicine, Valine, General Medicine, 030211 gastroenterology & hepatology, Macrocyclic Compound, medicine.drug, Human, medicine.medical_specialty, Proline, Lactams, Macrocyclic, Settore MED/12 - GASTROENTEROLOGIA, Liver Cirrhosi, Sulfonamide, 03 medical and health sciences, Internal medicine, Decompensation, Hepatitis, Antiviral Agent, Cirrhosi, Hepaciviru, business.industry, Settore MED/09 - MEDICINA INTERNA, Anilide, Biomarker, medicine.disease, chemistry, Carbamate, business
Abstract

Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100mg) and twice-daily dasabuvir (250mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter defined as HCV RNA negative 12weeks after the end of treatment (SVR12). Results: Patients who suffered any adverse event (AE) were 74/240 (30.8%); 13/240 (5.4%) discontinued the treatment. A multivariate analysis found albumin < 3.5g/dL (OR 2.04: 95% CI 1.0–4.2, p < 0.05) and hypertension (OR 4.6: 95% CI 2.3–9.2, p < 0.001) as variables independently associated with AE occurrence. The SVR12 was 95% (228/240). Multivariate analysis identified baseline bilirubin < 2mg/dL (OR 4.9: 95% CI 1.17–20.71, p = 0.029) as the only variable independently associated with SVR12. Conclusion: Our findings suggest that OBV/PTV/r + DSV + RBV is safe and effective in real-life use in patients with compensated cirrhosis, HCV-GT1 infection, and age over 65.

Published
2018

10. Clinical and prognostic implications of acute onset of Autoimmune Hepatitis: An Italian multicentre study

Author

Giampaolo Bianchi, Paolo Muratori, Pietro Invernizzi, Claudine Lalanne, Giorgia Stangos, Marco Lenzi, Vincenzo Ronca, Marco Carbone, Luigi Muratori, Annarosa Floreani, L. Perini, Nora Cazzagon, Muratori, Paolo, Carbone, Marco, Stangos, Giorgia, Perini, Lisa, Lalanne, Claudine, Ronca, Vincenzo, Cazzagon, Nora, Bianchi, Giampaolo, Lenzi, Marco, Floreani, Annarosa, Invernizzi, Pietro, Muratori, Luigi, Muratori, P, Carbone, M, Stangos, G, Perini, L, Lalanne, C, Ronca, V, Cazzagon, N, Bianchi, G, Lenzi, M, Floreani, A, Invernizzi, P, and Muratori, L

Subjects
Liver Cirrhosis, Male, Cirrhosis, medicine.medical_treatment, Azathioprine, Autoimmune hepatitis, Adrenal Cortex Hormone, Gastroenterology, Liver disease, 0302 clinical medicine, Adrenal Cortex Hormones, Retrospective Studie, Autoimmune disease, Child, Aged, 80 and over, Immunosuppression, Middle Aged, Prognosis, Hepatitis, Autoimmune, Liver, Italy, 030220 oncology & carcinogenesis, Child, Preschool, Acute Disease, Disease Progression, 030211 gastroenterology & hepatology, Female, medicine.drug, Human, Adult, medicine.medical_specialty, Adolescent, Logistic Model, Prognosi, Liver Cirrhosi, Transaminase, 03 medical and health sciences, Young Adult, Internal medicine, Hepatology, medicine, Humans, International Normalized Ratio, Transaminases, Retrospective Studies, Aged, business.industry, Retrospective cohort study, Bilirubin, medicine.disease, digestive system diseases, Logistic Models, business
Abstract

Autoimmune Hepatitis (AIH) can present under clinical profile as acute hepatitis of unexplained cause. We analyzed clinical, therapeutical and prognostic implications of AIH presenting as acute hepatitis in a cohort of patients admitted to 3 referral Centres in Italy. AIH onset was considered acute when transaminases were higher than 10 times the normal limit and/or bilirubin higher than 5 mg/ml (irrespectively from the histology, available only in 62% of cases). Among 479 patients diagnosed as AIH, 202 (43%) met the criteria of acute onset. This former group of patients on the basis of the histology has been subdivided in the "genuine" acute onset (83 pts) and acute "on chronic" onset (45 pts) At onset, clinical acute AIH showed significantly higher ALT, bilirubin and INR levels (p < 0.001 for all), lower albumin values (p = 0.001), similar IgG levels; Response to treatment was similar between the two groups. The progression to liver cirrhosis or its complications was significantly less frequent in acute onset AIH (13% vs. 22%, p = 0.02). The "genuine" acute patients showed a higher albumin serum levels (40 vs. 36, p = 0.001), lower INR levels (1.12 vs. 1.26, p = 0.002) and less tendency to the progression of liver disease (7% vs. 12%, p = NS) with respect to acute "on chronic" onset patients. Clinical acute hepatitis represents a common presentation of AIH, responds to standard immunosuppression regimen and would seem to be correlated with a better long-term prognosis.

Published
2018

11. Diagnostic approach to autoimmune hepatitis

Author

Luigi Muratori, Paolo Muratori, Marco Lenzi, Fabio Cassani, Claudine Lalanne, Muratori, Paolo, Lenzi, Marco, Cassani, Fabio, Lalanne, Claudine, and Muratori, Luigi

Subjects
0301 basic medicine, Cirrhosis, Anti-nuclear antibody, Immunology, Myocytes, Smooth Muscle, MEDLINE, Disease, Autoimmune hepatitis, Autoimmune hepatiti, Immunologic Tests, pattern, anti smooth muscle antibodie, 03 medical and health sciences, Liver disease, 0302 clinical medicine, medicine, Immunology and Allergy, Animals, Humans, interface hepatiti, Pathology, Molecular, Autoantibodies, business.industry, Autoantibody, medicine.disease, autoantibodie, Hepatitis, Autoimmune, 030104 developmental biology, Liver, Antibodies, Antinuclear, 030211 gastroenterology & hepatology, Differential diagnosis, liver kidney microsome type 1, business, antinuclear antibodie, hypergammaglobulinemia, Biomarkers
Abstract

Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease which, if left without treatment, can evolve into cirrhosis and possibly liver failure. The diagnosis of AIH is hampered by the lack of specific and reliable markers of the disease and a number of clinical, biochemical, immunological, histological and genetic factors should be considered to reach a confident diagnosis Areas covered: Clinical expression of AIH, histological features, serological and genetic profiles, differential diagnosis, overlap with other autoimmune liver diseases, assessed on the basis of personal experience and review of published literature in the last 10Â years through a systematic Medline search (keywords: autoimmune hepatitis, diagnosis) Expert commentary: Notwithstanding numerous efforts to identify simple and reliable markers of the disease, the diagnosis of AIH is still based on the combination of histological, immunological and biochemical features and often can represent a real challenge for the hepatologist.

Published
2017

12. Clinical usefulness of serum antibodies as biomarkers of gastrointestinal and liver diseases

Author

Marco Lenzi, Luca Frulloni, Federico Biagi, Antonio Di Sabatino, Paolo Giuffrida, Gino Roberto Corazza, Marco Vincenzo Lenti, Di Sabatino, Antonio, Biagi, Federico, Lenzi, Marco, Frulloni, Luca, Lenti, Marco Vincenzo, Giuffrida, Paolo, and Corazza, Gino Roberto

Subjects
medicine.medical_specialty, Atrophic gastritis, Gastrointestinal Diseases, Autoimmune hepatitis, Autoimmune enteropathy, Autoimmune atrophic gastritis, Autoimmune liver disease, Autoimmune pancreatitis, Coeliac disease, Inflammatory bowel disease, Gastroenterology, Primary sclerosing cholangitis, 03 medical and health sciences, Autoimmune atrophic gastriti, 0302 clinical medicine, Internal medicine, Medicine, Humans, Polyendocrinopathies, Autoimmune, Autoantibodies, Hepatology, biology, business.industry, Liver Diseases, medicine.disease, Pancreatitis, 030220 oncology & carcinogenesis, biology.protein, 030211 gastroenterology & hepatology, Antibody, business, Biomarkers, Autoimmune pancreatiti
Abstract

The progressively growing knowledge of the pathophysiology of a number of immune-mediated gastrointestinal and liver disorders, including autoimmune atrophic gastritis, coeliac disease, autoimmune enteropathy, inflammatory bowel disease, autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis and autoimmune pancreatitis, together with the improvement of their detection methods have increased the diagnostic power of serum antibodies. In some cases – coeliac disease and autoimmune atrophic gastritis – they have radically changed gastroenterologists’ diagnostic ability, while in others – autoimmune hepatitis, inflammatory bowel disease and autoimmune pancreatitis – their diagnostic performance is still inadequate. Of note, serum antibody misuse in clinical practice has raised a number of controversies, which may generate confusion in the diagnostic management of the aforementioned disorders. In this review, we critically re-evaluate the usefulness of serum antibodies as biomarkers of immune-mediated gastrointestinal and liver disorders, and discuss their pitfalls and merits.

Published
2017

13. Accuracy of elastography point quantification and steatosis influence on assessing liver fibrosis in patients with chronic hepatitis C

Author

Pietro Andreone, Marco Lenzi, Gabriella Verucchi, Antonietta D'Errico, Ranka Vukotic, E Fiorini, Carla Serra, Fabio Conti, Elena Mazzotta, Cristina Felicani, Conti, Fabio, Serra, Carla, Vukotic, Ranka, Fiorini, Erica, Felicani, Cristina, Mazzotta, Elena, D'Errico, Antonietta, Verucchi, Gabriella, Lenzi, Marco, and Andreone, Pietro

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, steatosi, point shear wave elastography, Severity of Illness Index, Gastroenterology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Fibrosis, Internal medicine, steatosis, medicine, Humans, Obesity, Prospective Studies, liver fibrosis, medicine.diagnostic_test, Hepatology, business.industry, Fatty liver, liver fibrosi, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Data Accuracy, Fatty Liver, hepatitis C, Cross-Sectional Studies, Italy, ROC Curve, Liver biopsy, Multivariate Analysis, Linear Models, Elasticity Imaging Techniques, Female, 030211 gastroenterology & hepatology, Elastography, Hepatic fibrosis, business, Viral hepatitis
Abstract

Background & Aims Elastography point quantification is a novel non-invasive method for the assessment of liver fibrosis by measuring liver stiffness. The aim of this study was to evaluate the accuracy of elastography point quantification for the diagnosis of liver fibrosis and to assess impact of steatosis on liver stiffness measurement, in a cohort of patients with chronic hepatitis C. Methods In this single-centre cross-sectional study, 211 consecutive patients with chronic hepatitis C, scheduled for liver biopsy, were examined with the elastography point quantification technology. On the same day, all patients underwent clinical examination, laboratory tests and abdominal ultrasound. Results The best cut-offs of liver stiffness measurement were 6.16 kPa for the diagnosis of significant fibrosis (≥S3) and 6.79 kPa for advanced fibrosis (≥S4). Areas under the receiver operating characteristic curve were 0.831 (CI: 0.773–0.880) for significant fibrosis, and 0.954 (CI: 0.916–0.978) for advanced fibrosis. Among patients within the same fibrosis stages (S0–S2 and S3–S6; S0–S3 and S4–S6), mean liver stiffness measurement values were similar in patients with steatosis (≥10% at liver biopsy or detected by ultrasound) compared to those without. Discordance between elastography point quantification and histology were affected by the presence of BMI>30 kg/m2 (P=.047, CI: 0.136–0.988 and P=.020, CI: 0.083–0.812 respectively). Conclusions In patients with chronic hepatitis C, elastography point quantification is an accurate non-invasive method for the diagnosis of significant and advanced fibrosis. The presence of obesity is a risk factor for misclassification of significant and advanced liver fibrosis.

Published
2017

14. Imbalance of Neutrophils and Lymphocyte Counts Can Be Predictive of Hepatocellular Carcinoma Occurrence in Hepatitis C-related Cirrhosis Treated With Direct-acting Antivirals

Author

Andrea Casadei Gardini, Paolo Caraceni, Maria Cristina Morelli, Fabio Conti, Marco Lenzi, Mauro Bernardi, Stefano Brillanti, Cristina Crespi, Paolo Muratori, Lorenzo Badia, Pietro Andreone, Francesco Giuseppe Foschi, Giuseppe Mazzella, Gabriella Verucchi, Sonia Berardi, Federico Ravaioli, Federica Buonfiglioli, Luigi Bolondi, Casadei Gardini, Andrea, Conti, Fabio, Foschi, Francesco Giuseppe, Brillanti, Stefano, Andreone, Pietro, Mazzella, Giuseppe, Ravaioli, Federico, Buonfiglioli, Federica, Bolondi, Luigi, Crespi, Cristina, Lenzi, Marco, Muratori, Paolo, Verucchi, Gabriella, Badia, Lorenzo, Bernardi, Mauro, Caraceni, Paolo, Morelli, Maria Cristina, and Berardi, Sonia

Subjects
Liver Cirrhosis, 0301 basic medicine, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Neutrophils, Liver Cirrhosi, Lymphocyte, DIRECT ACTING ANTIVIRALS, Antiviral Agents, Hepatology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Humans, Lymphocyte Count, Antiviral Agent, business.industry, Neutrophil, Liver Neoplasms, Hepatocellular, Hepatitis C, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, business, Human
Abstract

N/A

Published
2018

15. Reply to 'further considerations in autoimmune hepatitis'

Author

Ansgar W. Lohse, Frank Lammert, Michael A. Heneghan, Joost P.H. Drenth, Olivier Chazouillères, George N. Dalekos, Harald Hofer, Marco Lenzi, Lohse, Ansgar W., Chazouilleres, Olivier, Dalekos, George, Drenth, Joost P., Heneghan, Michael, Hofer, Harald, Lammert, Frank, and Lenzi, Marco

Subjects
medicine.medical_specialty, Hepatology, business.industry, animal diseases, chemical and pharmacologic phenomena, Autoimmune hepatitis, biochemical phenomena, metabolism, and nutrition, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Internal medicine, Immunology, medicine, bacteria, 030211 gastroenterology & hepatology, business
Abstract

replay to further considerations in auto immune hepatitis

Published
2016

16. Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals

Author

Paolo Caraceni, A. Scuteri, Federica Buonfiglioli, Cristina Crespi, Francesco Giuseppe Foschi, Fabio Conti, Gabriella Verucchi, Pietro Andreone, Marco Lenzi, Stefano Brillanti, Giuseppe Mazzella, Luigi Bolondi, Conti, Fabio, Buonfiglioli, Federica, Scuteri, Alessandra, Crespi, Cristina, Bolondi, Luigi, Caraceni, Paolo, Foschi, Francesco Giuseppe, Lenzi, Marco, Mazzella, Giuseppe, Verucchi, Gabriella, Andreone, Pietro, Brillanti, Stefano, DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, AREA MIN. 06 - Scienze mediche, and Da definire

Subjects
Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Sofosbuvir, Hepatocellular carcinoma, Gastroenterology, Antiviral Agents, Direct-Acting antiviral, HCC development, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Model for End-Stage Liver Disease, Internal medicine, medicine, Humans, Cancer immunosurveillance, Chronic, neoplasms, Cirrhosi, HCC recurrence, Hepatology, business.industry, Hepatitis C virus, Interferon-free therapy, Carcinoma, Liver Neoplasms, Hepatocellular, Hepatitis C, Direct-Acting antivirals, HCC occurrence, HCC prevention, Sustained virological response, Hepatitis C, Chronic, Neoplasm Recurrence, Local, Carcinoma, Hepatocellular, medicine.disease, digestive system diseases, Neoplasm Recurrence, Local, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Liver cancer, business, Hepatitis C viru, medicine.drug
Abstract

none 12 no Background & Aims Hepatocellular carcinoma (HCC) represents a serious complication of HCV-related cirrhosis. New direct-acting antivirals (DAA) cure HCV infection in over 90% of patients. The aim of this study was to evaluate the early occurrence and recurrence of HCC in cirrhotic patients treated with DAA. Methods We analysed 344 consecutive cirrhotic patients, without HCC, who were treated with DAA, and followed for 24 weeks. Fifty-nine patients had previous HCC. Results DAA therapy induced sustained virological response in 91% of patients. During 24-week follow-up, HCC was detected in 26 patients (7.6%, 95% CI: 4.99–10.84): 17 of 59 patients (28.81%, 95% CI: 17.76–42.07) with previous HCC and 9 of 285 patients (3.16%, 95% CI: 1.45–5.90) without previous HCC. Child-Pugh Class B, more severe liver fibrosis, lower platelet count, and previous HCC were significantly associated with HCC development, at univariate analysis. At multivariate analysis, Child-Pugh class (p = 0.03, OR: 4.18, 95% CI: 1.17–14.8) and history of HCC (p

Published
2016

17. Features and Progression of Asymptomatic Autoimmune Hepatitis in Italy

Author

Fabio Cassani, Luigi Muratori, Erica Barbato, Angela Fabbri, Claudine Lalanne, Paolo Muratori, Marco Lenzi, Muratori, Paolo, Lalanne, Claudine, Barbato, Erica, Fabbri, Angela, Cassani, Fabio, Lenzi, Marco, and Muratori, Luigi

Subjects
Adult, Male, medicine.medical_specialty, Anti-nuclear antibody, Autoimmune hepatitis, Gastroenterology, Asymptomatic, Young Adult, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Internal medicine, medicine, Humans, Retrospective Studies, Subclinical infection, Asymptomatic Diseases, Outcome, Hepatology, Histocytochemistry, business.industry, Autoantibody, Middle Aged, Jaundice, medicine.disease, Autoantibodie, Hepatitis, Autoimmune, Italy, Liver, 030220 oncology & carcinogenesis, Immunology, Disease Progression, 030211 gastroenterology & hepatology, Female, medicine.symptom, business, Immunosuppressive Agents, Human
Abstract

Background & Aims: Patients with autoimmune hepatitis (AIH) can present with symptoms ranging from those that are insidious and nonspecific to acute hepatitis with jaundice. However, some patients have no symptoms at diagnosis and are identified incidentally. We investigated disease progression and outcomes of these 2 groups of patients. Methods: We performed a retrospective study to compare clinical, immunologic, and histologic features and outcomes of patients with asymptomatic vs symptomatic AIH. We analyzed data collected from 305 patients (90 asymptomatic and 215 with symptoms), diagnosed with AIH from 1994 and 2013, at the Center for the Study and Treatment of the Autoimmune Diseases of the Liver and Biliary System in Bologna, Italy. Results: At diagnosis, patients with asymptomatic AIH had significantly lower mean levels of alanine aminotransferase (7.0- ± 8.0-fold the upper limit of normal) than patients with symptomatic disease (23.0- ± 18.0-fold the upper limit of normal; P < .001), and lower mean levels of bilirubin (1.4 ± 1.4 mg/dL vs 8.6 ± 10.4 mg/dL; P < .001). Asymptomatic patients also had significantly lower histologic grades (7.0 ± 2.5) than symptomatic patients (9.0 ± 2.9; P < .001). However, larger proportions of asymptomatic patients had anti-liver/kidney microsomal antibodies type 1 (26.8% vs 13.1%; P < .006), and associated autoimmune thyroid (26.7% vs 12.6%; P = .003) or skin (8.9% vs 2.3%; P = .010) disorders. Age at onset, sex, response to therapy, disease progression, genetic factors, and other autoantibody markers did not differ between patients with asymptomatic vs symptomatic disease. Conclusions: Patients with asymptomatic vs symptomatic AIH have similar courses of disease progression and responses to immunosuppressive agents, and therefore should receive the same treatment. Patients affected by thyroid or dermatologic autoimmune disorders are at increased risk of developing subclinical liver disease, and should be assessed routinely for AIH.

Published
2016

18. Antimitochondrial antibodies positive autoimmune hepatitis with acute onset

Author

Luigi Muratori, Marco Lenzi, Marina Migliori, Paolo Muratori, Muratori, Paolo, Lenzi, Marco, Migliori, Marina, and Muratori, Luigi

Subjects
Hepatitis, medicine.medical_specialty, Past medical history, medicine.diagnostic_test, business.industry, Gastroenterology, Autoantibody, Azathioprine, Autoimmune hepatitis, Gastroenterology, PRIMARY BILIARY-CIRRHOSIS, Jaundice, medicine.disease, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Primary biliary cirrhosis, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, medicine.symptom, business, Liver function tests, medicine.drug
Abstract

Sir,We describe the case of a 47-year-old Italian woman referred to our unit following the appearance of jaundice with hyperchromic urine and hypocholic fecies. Past medical history documented only...

Published
2017

19. Autoimmune liver disease and concomitant extrahepatic autoimmune disease

Author

Marco Lenzi, Claudine Lalanne, Luigi Muratori, Angela Fabbri, Paolo Muratori, Muratori, Paolo, Fabbri, Angela, Lalanne, Claudine, Lenzi, Marco, and Muratori, Luigi

Subjects
Adult, Male, endocrine system diseases, Adolescent, Biopsy, autoimmune disease, Autoimmunity, Autoimmune hepatitis, medicine.disease_cause, Autoimmune Diseases, primary biliary cirrhosi, Young Adult, Primary biliary cirrhosis, immune system diseases, Retrospective Studie, Risk Factors, medicine, Humans, Child, autoimmune hepatiti, Aged, Autoantibodies, Retrospective Studies, Autoimmune disease, Hepatitis, Aged, 80 and over, medicine.diagnostic_test, Hepatology, business.industry, Risk Factor, Gastroenterology, nutritional and metabolic diseases, Retrospective cohort study, Middle Aged, medicine.disease, Autoantibodie, digestive system diseases, Hepatitis, Autoimmune, Liver, Concomitant, Child, Preschool, Immunology, Female, business, Human
Abstract

Aim To assess the frequency and clinical impact of associated extrahepatic autoimmune diseases (EAD) on autoimmune liver diseases (ALD). Patients and methods We investigated 608 patients with ALD (327 autoimmune hepatitis - AIH and 281 primary biliary cirrhosis - PBC) for concomitant EAD. Results In both AIH and PBC, we observed a high prevalence of EAD (29.9 and 42.3%, respectively); both diseases showed a significant association with autoimmune thyroid disease, followed by autoimmune skin disease, celiac disease, and vasculitis in AIH patients and sicca syndrome, CREST syndrome, and celiac disease in PBC patients. At diagnosis, AIH patients with concurrent EAD were more often asymptomatic than patients with isolated AIH (P

Published
2015

20. EASL Clinical Practice Guidelines: Autoimmune hepatitis

Author

Drenth, J.P.H. and Lenzi, Marco

Subjects
medicine.medical_specialty, Pathology, Hepatology, business.industry, Alternative medicine, Gastroenterology, Disease Management, Autoimmune hepatitis, medicine.disease, Antiviral Agents, United States, Clinical Practice, Hepatitis, Autoimmune, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], medicine, Humans, business, Intensive care medicine, clilical pratical guidelines, autoimmune hepatiti
Abstract

The aim of the present Clinical Practice Guideline (CPG) is to provide guidance to hepatologists and general physicians in the diagnosis and treatment of AIH in order to improve care for affected patients. In view of the limited data from large con- trolled studies and trials, many recommendations are based on expert consensus. This is to some extent a limitation of this EASL-CPG, but at the same time it is its special strength: consen- sus in this guideline is based on intensive discussions of experts from large treatment centres. The core consensus group has experience of over one thousand AIH patients managed person- ally, and the recommendations have been reviewed by both the EASL Governing Board as well as external experts, who have a similarly wide personal experience. Therefore, the guidelines are a resource of information and recommendations based on the largest experience available thus far. At the same time, we formulate key scientific questions that result from the consensus discussions on the limitations of our knowledge. All recommen- dations of this CPG were agreed upon unanimously (100%) con- sensus. Grading of the recommendations is based on the GRADE system for evidence

Published
2015

21. Epstein-Barr Virus as a Trigger of Autoimmune Liver Diseases

Author

Dimitrios P. Bogdanos, Daniel S. Smyk, Claire Elizabeth Matthews, Charalambos Billinis, Andrew K. Burroughs, Eirini I. Rigopoulou, Marco Lenzi, Rigopoulou, Eirini I., Smyk, Daniel S., Matthews, Claire E., Billinis, Charalambo, Burroughs, Andrew K., Lenzi, Marco, and Bogdanos, Dimitrios P.

Subjects
Autoimmune disease, business.industry, Review Article, Autoimmune hepatitis, medicine.disease, medicine.disease_cause, Epstein–Barr virus, Virology, Microbiology, Virus, QR1-502, Primary sclerosing cholangitis, Pathogenesis, Infectious Diseases, Primary biliary cirrhosis, Immune system, hemic and lymphatic diseases, Immunology, medicine, business
Abstract

The pathogenesis of autoimmune diseases includes a combination of genetic factors and environmental exposures including infectious agents. Infectious triggers are commonly indicated as being involved in the induction of autoimmune disease, with Epstein-Barr virus (EBV) being implicated in several autoimmune disorders. EBV is appealing in the pathogenesis of autoimmune disease, due to its high prevalence worldwide, its persistency throughout life in the host's B lymphocytes, and its ability to alter the host's immune response and to inhibit apoptosis. However, the evidence in support of EBV in the pathogenesis varies among diseases. Autoimmune liver diseases (AiLDs), including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC), have a potential causative link with EBV. The data surrounding EBV and AiLD are scarce. The lack of evidence surrounding EBV in AiLD may also be reflective of the rarity of these conditions. EBV infection has also been linked to other autoimmune conditions, which are often found to be concomitant with AiLD. This paper will critically examine the literature surrounding the link between EBV infection and AiLD development. The current evidence is far from being conclusive of the theory of a link between EBV and AiLD. © 2012 Eirini I. Rigopoulou et al.

Published
2012

22. Antifilamentous Actin Antibodies by ELISA for the Diagnosis of Type 1 Autoimmune Hepatitis

Author

Paolo Muratori, Luigi Muratori, Pappas Georgios, Marco Lenzi, Francesco B. Bianchi, Alessandro Granito, Granito, Alessandro, Muratori, Paolo, Muratori, Luigi, Pappas, Georgio, Lenzi, Marco, and Bianchi, Francesco Bianco

Subjects
Hepatitis, Pathology, medicine.medical_specialty, Hepatology, biology, business.industry, Liver Disease, Gastroenterology, IIf, Autoimmune hepatitis, medicine.disease, SMA, Hepatitis, Autoimmune, Prospective analysis, Titer, Predictive value of tests, medicine, biology.protein, Antibody, business, Interface hepatitis
Abstract

TO THE EDITOR: We read with interest the paper by Frenzel et al. (1) assessing the diagnostic value of antibodies to filamentous-actin (A-FAA) detected by ELISA in patients with autoimmune hepatitis (AIH). The authors compared the diagnostic value of A-FAA with that of smooth muscle antibodies (SMA) detected by indirect immunofluorescence (IIF). The evaluation of the diagnostic performance of A-FAA and SMA was performed at various cutoffs. In a retrospective analysis of 47 SMA-positive AIH patients A-FAA showed a sensitivity of 100% using a cutoff of 20 units. Moreover, in a prospective analysis of 123 patients with various liver diseases (35 of whom had AIH), A-FAA showed a higher sensitivity than SMA (74% vs 34%) when the cutoffs were 20 units and titer 1:40, respectively.

Published
2007

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