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3. Effect of prednisone priming followed by alfa-interferon in treatment of children with chronic hepatitis B: an interim analysis of a controlled trial

Author

Utili, Riccardo, Sagnelli, E., Giusti, G., Ruggiero, G., Piccinino, F., Galanti, B., Adinolfi, L. E., Aprea, L., Cesaro, G., Digilio, L., Felaco, F. M., Filippini, P., Gaeta, G. B., Marrone, A., Nardiello, S., Pasquale, G., Pizzella, T., Russo, M., Santarpia, L., Sardaro, C., D’Amora, T., De Bac, C., editor, Taliani, G., editor, and Gerlich, W. H., editor

Published
1992
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15. Effect of prednisone priming followed by alfa-interferon in treatment of children with chronic hepatitis B: an interim analysis of a controlled trial

Author

Utili, Riccardo, primary, Sagnelli, E., additional, Giusti, G., additional, Ruggiero, G., additional, Piccinino, F., additional, Galanti, B., additional, Adinolfi, L. E., additional, Aprea, L., additional, Cesaro, G., additional, Digilio, L., additional, Felaco, F. M., additional, Filippini, P., additional, Gaeta, G. B., additional, Marrone, A., additional, Nardiello, S., additional, Pasquale, G., additional, Pizzella, T., additional, Russo, M., additional, Santarpia, L., additional, Sardaro, C., additional, and D’Amora, T., additional

Published
1992
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17. Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting

Author

Prati, D, Gasbarrini, A, Mazzotta, F, Sagnelli, E, Carosi, G, Abrescia, N, Alberti, Alfredo, Ambu, S, Andreone, P, Andriulli, A, Angelico, M, Antonucci, G, Ascione, A, Belli, Ls, Bruno, R, Bruno, S, Burra, Patrizia, Camma, C, Caporaso, N, Cariti, G, Cillo, U, Coppola, N, Craxi, A, DE LUCA, A, DE MARTIN, E, DI MARCO, V, Fagiuoli, S, Ferrari, C, Gaeta, Gb, Galli, M, Grieco, A, Grossi, P, Licata, A, Maida, I, Mangia, A, Marino, N, Maserati, R, Missale, G, Mondelli, M, Nasta, P, Niro, G, Persico, M, Petrelli, E, Picciotto, A, Piscaglia, F, Pollicino, T, Puoti, C, Puoti, M, Raimondo, G, Rumi, Mg, Santantonio, T, Smedile, A, Squadrito, G, Baroni, Gs, Taliani, G, Tavio, M, Toti, M, Bonino, F, Brunetto, Mr, Cacopardo, B, Caremani, M, Cauda, R, Colombo, M, DI PERRI, G, Donato, F, Farci, P, Fattovich, G, Filice, G, Ghinelli, F, Guadagnino, V, Lazzarin, A, Levrero, M, Licata, G, Orani, A, Paffetti, A, Pastore, G, Piccinino, F, Pizzigallo, E, Pontisso, Patrizia, Portelli, V, Rizzetto, M, Rossi, A, Stroffolini, T, Ubaldi, E, Santantanio, T, Alberti, A., Antonucci, Gf, Craxi, A., Prati D, Gasbarrini A, Mazzotta F, Sagnelli E, Carosi G, Abrescia N, Alberti A, Ambu S, Andreone P, Andriulli A, Angelico M, Antonucci GF, Ascione A, Belli LS, Bruno R, Bruno S, Burra P, Cammà, C, Caporaso N, Cariti G, Cillo U, Coppola N, Craxì, A, De Luca A, De Martin E, Di Marco, V, Fagiuoli S, Ferrari C, Gaeta GB, Galli M, Grieco A, Grossi P, Licata, A, Maida I, Mangia A, Marino N, Maserati R, Missale G, Mondelli M, Nasta P, Niro G, Persico M, Petrelli E, Picciotto A, Piscaglia F, Pollicino T, Prati D, Puoti C, Puoti M, Raimondo G, Rumi MG, Sagnelli E, Santantonio T, Smedile A, Squadrito G, Baroni GS, Taliani G, Tavio M, Toti M, Bonino F, Brunetto MR, Cacopardo B, Caremani M, Cauda R, Colombo M, Di Perri G, Donato F, Farci P, Fattovich G, Filice G, Ghinelli F, Guadagnino V, Lazzarin A, Levrero M, Licata G, Orani A, Paffetti A, Pastore G, Piccinino F, Pizzigallo E, Pontisso P, Portelli V, Rizzetto M, Rossi A, Stroffolini T, Ubaldi E., Italian Association for the Study of the Liver, Italian Society of Infectious, Tropical Disease, Italian Society for the Study of Sexually Transmitted Diseases: Prati D., Gasbarrini A., Mazzotta F., Sagnelli E., Carosi G., Abrescia N., Alberti A., Ambu S., Andreone P., Andriulli A., Angelico M., Antonucci G.F., Ascione A., Belli L.S., Bruno R., Bruno S., Burra P., Cammà C., Caporaso N., Cariti G., Cillo U., Coppola N., Craxì A., De Luca A., De Martin E., Di Marco V., Fagiuoli S., Ferrari C., Gaeta G.B., Galli M., Grieco A., Grossi P., Licata A., Maida I., Mangia A., Marino N., Maserati R., Missale G., Mondelli M., Nasta P., Niro G., Persico M., Petrelli E., Picciotto A., Piscaglia F., Pollicino T., Puoti C., Puoti M., Raimondo G., Rumi M.G., Santantonio T., Smedile A., Squadrito G., Baroni G.S., Taliani G., Tavio M., Toti M., Bonino F., Brunetto M.R., Cacopardo B., Caremani M., Cauda R., Colombo M., Di Perri G., Donato F., Farci P., Fattovich G., Filice G., Ghinelli F., Guadagnino V., Lazzarin A., Levrero M., Licata G., Orani A., Paffetti A., Pastore G., Piccinino F., Pizzigallo E., Pontisso P., Portelli V., Rizzetto M., Rossi A., Stroffolini T., Ubaldi E., Prati, D, Gasbarrini, A, Mazzotta, F, Sagnelli, E, Carosi, G, Abrescia, N, Alberti, A, Ambu, S, Andreone, P, Andriulli, A, Angelico, M, Antonucci, G, Ascione, A, Belli, L, Bruno, R, Bruno, S, Burra, P, Caporaso, N, Cariti, G, Cillo, U, Coppola, N, De Luca, A, De Martin, E, Fagiuoli, S, Ferrari, C, Gaeta, G, Galli, M, Grieco, A, Grossi, P, Maida, I, Mangia, A, Marino, N, Maserati, R, Missale, G, Mondelli, M, Nasta, P, Niro, G, Persico, M, Petrelli, E, Picciotto, A, Piscaglia, F, Pollicino, T, Puoti, C, Puoti, M, Raimondo, G, Rumi, M, Santantonio, T, Smedile, A, Squadrito, G, Baroni, G, Taliani, G, Tavio, M, Toti, M, Bonino, F, Brunetto, M, Cacopardo, B, Caremani, M, Cauda, R, Colombo, M, Di Perri, G, Donato, F, Farci, P, Fattovich, G, Filice, G, Ghinelli, F, Guadagnino, V, Lazzarin, A, Levrero, M, Licata, G, Orani, A, Paffetti, A, Pastore, G, Piccinino, F, Pizzigallo, E, Pontisso, P, Portelli, V, Rizzetto, M, Rossi, A, Stroffolini, T, and Ubaldi, E

Subjects
Liver Cirrhosis, ANTIVIRAL TREATMENT, Human immunodeficiency virus (HIV), HIV Infections, Hepacivirus, ANTIVIRAL THERAPY, PEGYLATED INTERFERON-ALPHA-2B, LIVER-TRANSPLANTATION, PEGINTERFERON ALPHA-2A, HIV-INFECTED PATIENTS, VIRUS-COINFECTED PATIENTS, RAPID VIROLOGICAL RESPONSE, Antiviral therapy, medicine.disease_cause, Gastroenterology, Polyethylene Glycols, HBV, guidelines, Acute hepatitis, Chronic hepatitis, Settore MED/12 - Gastroenterologia, liver transplantation, Hepatitis C, Recombinant Proteins, acute hepatitis, antiviral therapy, chronic hepatitis, cirrhosis, elderly patients, hbv, hcv, hdv, hiv, CLINICAL PRACTICE GUIDELINES, Cirrhosis, HCV, Drug Therapy, Combination, Antiviral therapy Acute hepatitis Chronic hepatitis,Cirrhosis, Elderly patients, HBV, HCV, HDV, HIV Liver transplantation, Elderly patient, Acute hepatiti, medicine.medical_specialty, Genotype, Alpha interferon, Interferon alpha-2, CHRONIC HEPATITIS C, Antiviral Agents, Hepatitis B, Chronic, Internal medicine, HDV, Drug Resistance, Viral, Ribavirin, medicine, Humans, Cirrhosi, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, Interferon-alpha, HIV, Hepatitis C, Chronic, medicine.disease, Elderly patients, Family medicine, Expert opinion, Chronic hepatiti, business
Abstract

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies.

Published
2010

18. Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study

Author

Stroffolini T., Almasio P. L., Sagnelli E., Mele A., Gaeta G. B., Italian Hospitals' Collaborating Group, Scuteri A., Antonucci G., Iacomi F., Babudieri S., Pintus A., Stornaiuolo G., Brancaccio G., Brunetto M., Sasso R., Caporaso N., Morisco F., Chiaramonte M., Lattanzi E., Di Marco V., Venezia G., Fagiuoli S., Boninsegna S., Fattovich G., Olivari N., Ferrari C., Giuberti T., Ferrigno L., Magnani G., Massari M., Mangano C., Caserta C., Messina V., Pastore G., Palattella S., Piccinino F., Stanzione M., Pinzello G., Vinci M., Raimondo G., Caccamo G., Roffi L., Bellia V., Rizzetto M., Smedile A., Ciancio A., ANDREONE, PIETRO, Infectious and Tropical Diseases, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Gastroenterology, Università degli studi di Palermo - University of Palermo, Public,Clinical and Preventive Medicine, University of Naples Federico II, Laboratory of Epidemiology, Clinical Epidemiology Unit, Istituto Superiore di Sanita [Rome], Infectious Diseases Dept, Stroffolini T., Almasio P.L., Sagnelli E., Mele A., Gaeta G.B., Italian Hospitals' Collaborating Group, Andreone P., Scuteri A., Antonucci G., Iacomi F., Babudieri S., Pintus A., Stornaiuolo G., Brancaccio G., Brunetto M., Sasso R., Caporaso N., Morisco F., Chiaramonte M., Lattanzi E., Di Marco V., Venezia G., Fagiuoli S., Boninsegna S., Fattovich G., Olivari N., Ferrari C., Giuberti T., Ferrigno L., Magnani G., Massari M., Mangano C., Caserta C., Messina V., Pastore G., Palattella S., Piccinino F., Stanzione M., Pinzello G., Vinci M., Raimondo G., Caccamo G., Roffi L., Bellia V., Rizzetto M., Smedile A., Ciancio A., Stroffolini, T, Almasio, P, Sagnelli, E, Mele, A, Gaeta, G, Andreone, P, Scuteri, A, Antonucci, G, Iacomi, F, Babudieri, S, Pintus, A, Stornaiuolo, G, Brancaccio, G, Brunetto, M, Sasso, R, Caporaso, N, Morisco, F, Chiaramonte, M, Lattanzi, E, Di Marco, V, Venezia, G, Fagiuoli, S, Boninsegna, S, Fattovich, G, Olivari, N, Ferrari, C, Giuberti, T, Ferrigno, L, Magnani, G, Massari, M, Mangano, C, Caserta, C, Messina, V, Pastore, G, Palattella, S, Piccinino, F, Stanzione, M, Pinzello, G, Vinci, M, Raimondo, G, Caccamo, G, Roffi, L, Bellia, V, Rizzetto, M, Smedile, A, and Ciancio, A

Subjects
Male, HBsAg, viruses, HIV Infections, Antibodies, Viral, HBeAg, Hepatitis, Liver disease, CHRONIC HEPATITIS B, epidemiology, GEOGRAPHICAL LANDSCAPE, 0302 clinical medicine, 80 and over, Prevalence, Viral, Chronic, Aged, 80 and over, 0303 health sciences, Geography, Age Factors, virus diseases, Hepatitis C, Hepatitis B, Middle Aged, Hepatitis D, 3. Good health, Infectious Diseases, Cirrhosis, Italy, Medicine, 030211 gastroenterology & hepatology, Female, Hepatitis D virus, Human, Adult, Hepatitis, Viral, Human, Adolescent, Antibodies, 03 medical and health sciences, Hepatitis B, Chronic, HDV, Virology, Cirrhosis, HBeAg, HDV, Hepatitis B, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antibodies, Viral, Cross-Sectional Studies, Female, Geography, HIV, HIV Infections, Hepatitis B, Chronic, Hepatitis, Viral, Human, Humans, Italy, Male, Middle Aged, Prevalence, Virology, Infectious Diseases, medicine, Aged, Cross-Sectional Studies, HIV, Humans, 030304 developmental biology, Cirrhosi, business.industry, medicine.disease, digestive system diseases, business
Abstract

The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross-sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period (incident cases), 14.3% were anti-HDV positive. Seven percent of the patients were immigrants; they were younger than Italian patients and 18% were HBeAg positive; no difference was observed in the prevalence of anti-HDV, anti-HCV, or anti-HIV antibodies. The presence of cirrhosis was associated independently with an age >52 years, the presence of anti-HDV or anti-HCV, alcohol use >4 drinks/day, and a high BMI. The clinical epidemiology of chronic hepatitis B virus (HBV) infection shows a dynamic profile, with the potential for re-emergence of cases with HBeAg or anti-HDV and an emerging impact of metabolic factors on the evolution of liver disease.

Published
2009
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19. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study

Author

BRUNO S, STROFFOLINI T, COLOMBO M, BOLLANI S, BENVEGNU L, MAZZELLA G, ASCIONE A, SANTANTONIO T, PICCININO F, ANDREONE P, MANGIA A, GAETA GB, PERSICO M, FAGIUOLI S, ALMASIO, Pier Luigi, ITALIAN ASSOCIATION OF THE STUDY OF THE LIVER DISEASE AISF, S. Bruno, T. Stroffolini, M. Colombo, S. Bollani, L. Benvegnu, G. Mazzella, A. Ascione, T. Santantonio, F. Piccinino, P. Andreone, A. Mangia, G.B. Gaeta, M. Persico, S. Fagiuoli, P.L. Almasio, BRUNO S, STROFFOLINI T, COLOMBO M, BOLLANI S, BENVEGNU L, MAZZELLA G, ASCIONE A, SANTANTONIO T, PICCININO F, ANDREONE P, MANGIA A, GAETA GB, PERSICO M, FAGIUOLI S, ALMASIO PL, ITALIAN ASSOCIATION OF THE STUDY OF THE LIVER DISEASE AISF, Bruno, S, Stroffolini, T, Colombo, M, Bollani, S, Benvegnù, L, Mazzella, G, Ascione, A, Santantonio, T, Piccinino, F, Andreone, P, Mangia, A, Gaeta, G, Persico, M, Fagiuoli, S, and Almasio, P

Subjects
Liver Cirrhosis, Male, ANTIVIRAL TREATMENT, Multivariate analysis, Cirrhosis, Hepacivirus, drug therapy/mortality/virology, Gastroenterology, Cohort Studies, INTERFERON, HEPATITIS C, CIRRHOSIS, CHRONIC HEPATITIS C, SUSTAINED VIROLOGICAL RESPONSE, Liver cirrhosis, Medicine, genetics, Longitudinal Studies, Viral, Hazard ratio, virus diseases, Hepatitis C, Adult, Antiviral Agents, therapeutic use, Cohort Studies, Female, Hepacivirus, genetics, Hepatitis C, blood/complications/drug therapy/mortality, Humans, Interferon-alpha, therapeutic use, Liver Cirrhosis, drug therapy/mortality/virology, Longitudinal Studies, Male, Middle Aged, Multivariate Analysis, RNA, blood, Retrospective Studies, Survival Analysis, Treatment Outcome, Middle Aged, Treatment Outcome, Liver Cirrhosis/drug therapy, Liver Cirrhosis/virology, RNA, Viral, Female, Adult, medicine.medical_specialty, Antiviral Agents, blood, Internal medicine, Humans, Retrospective Studies, Sustained virological response, interferon-alpha, HCV-related cirrhosis, Hepatology, business.industry, Proportional hazards model, Interferon-alpha, Retrospective cohort study, blood/complications/drug therapy/mortality, medicine.disease, Survival Analysis, digestive system diseases, Discontinuation, Surgery, therapeutic use, Multivariate Analysis, RNA, business
Abstract

The effect of achieving a sustained virological response (SVR) following interferon-α (IFNα) treatment on the clinical outcomes of patients with HCV-related cirrhosis is unknown. In an attempt to assess the risk of liver-related complications, HCC and liver-related mortality in patients with cirrhosis according to the response to IFNα treatment, a retrospective database was developed including all consecutive patients with HCV-related, histologically proven cirrhosis treated with IFNα monotherapy between January 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24 weeks after IFNα discontinuation. HCC was assessed by ultrasound every 6 months. Independent predictors of all outcomes were assessed by Cox regression analysis. Of 920 patients, 124 (13.5%) were classified as achieving a SVR. During a mean follow-up of 96.1 months (range: 6-167) the incidence rates per 100 person-years of liver-related complications, HCC and liver-related death were 0, 0.66, and 0.19 among SVR and 1.88, 2.10, and 1.44 among non-SVR (P < 0.001 by log-rank test). Multivariate analyses found that non-SVR was associated with a higher risk of liver-related complications (hazard ratio, HR, not applicable), HCC (HR 2.59; 95% CI 1.13-5.97) and liver-related mortality (HR 6.97; 95% CI 1.71-28.42) as compared to SVR. Conclusion: Thus, in patients with HCV-related, histologically proven cirrhosis, achievement of a SVR after IFNα therapy was associated with a reduction of liver-related mortality lowering both the risk of complications and HCC development. Irrespective of SVR achievement, all patients should continue surveillance because the risk of occurrence of HCC was not entirely avoided. (HEPATOLOGY 2007;45:579–587.)

Published
2007

20. Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study

Author

Stroffolini, T, Almasio, P, Sagnelli, E, Mele, A, Gaeta, G, Andreone, P, Scuteri, A, Antonucci, G, Iacomi, F, Babudieri, S, Pintus, A, Stornaiuolo, G, Brancaccio, G, Brunetto, M, Sasso, R, Caporaso, N, Morisco, F, Chiaramonte, M, Lattanzi, E, Di Marco, V, Venezia, G, Fagiuoli, S, Boninsegna, S, Fattovich, G, Olivari, N, Ferrari, C, Giuberti, T, Ferrigno, L, Magnani, G, Massari, M, Mangano, C, Caserta, C, Messina, V, Pastore, G, Palattella, S, Piccinino, F, Stanzione, M, Pinzello, G, Vinci, M, Raimondo, G, Caccamo, G, Roffi, L, Bellia, V, Rizzetto, M, Smedile, A, Ciancio, A, Stroffolini T, Almasio PL, Sagnelli E, Mele A, Gaeta GB, Andreone P, Scuteri A, Antonucci G, Iacomi F, Babudieri S, Pintus A, Stornaiuolo G, Brancaccio G, Brunetto M, Sasso R, Caporaso N, Morisco F, Chiaramonte M, Lattanzi E, Di Marco V, Venezia G, Fagiuoli S, Boninsegna S, Fattovich G, Olivari N, Ferrari C, Giuberti T, Ferrigno L, Magnani G, Massari M, Mangano C, Caserta C, Messina V, Pastore G, Palattella S, Piccinino F, Stanzione M, Pinzello G, Vinci M, Raimondo G, Caccamo G, Roffi L, Bellia V, Rizzetto M, Smedile A, Ciancio A. Italian Hospitals' Collaborating Group., Stroffolini, T, Almasio, P, Sagnelli, E, Mele, A, Gaeta, G, Andreone, P, Scuteri, A, Antonucci, G, Iacomi, F, Babudieri, S, Pintus, A, Stornaiuolo, G, Brancaccio, G, Brunetto, M, Sasso, R, Caporaso, N, Morisco, F, Chiaramonte, M, Lattanzi, E, Di Marco, V, Venezia, G, Fagiuoli, S, Boninsegna, S, Fattovich, G, Olivari, N, Ferrari, C, Giuberti, T, Ferrigno, L, Magnani, G, Massari, M, Mangano, C, Caserta, C, Messina, V, Pastore, G, Palattella, S, Piccinino, F, Stanzione, M, Pinzello, G, Vinci, M, Raimondo, G, Caccamo, G, Roffi, L, Bellia, V, Rizzetto, M, Smedile, A, Ciancio, A, Stroffolini T, Almasio PL, Sagnelli E, Mele A, Gaeta GB, Andreone P, Scuteri A, Antonucci G, Iacomi F, Babudieri S, Pintus A, Stornaiuolo G, Brancaccio G, Brunetto M, Sasso R, Caporaso N, Morisco F, Chiaramonte M, Lattanzi E, Di Marco V, Venezia G, Fagiuoli S, Boninsegna S, Fattovich G, Olivari N, Ferrari C, Giuberti T, Ferrigno L, Magnani G, Massari M, Mangano C, Caserta C, Messina V, Pastore G, Palattella S, Piccinino F, Stanzione M, Pinzello G, Vinci M, Raimondo G, Caccamo G, Roffi L, Bellia V, Rizzetto M, Smedile A, and Ciancio A. Italian Hospitals' Collaborating Group.

Abstract

The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross-sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period (incident cases), 14.3% were anti-HDV positive. Seven percent of the patients were immigrants; they were younger than Italian patients and 18% were HBeAg positive; no difference was observed in the prevalence of anti-HDV, anti-HCV, or anti-HIV antibodies. The presence of cirrhosis was associated independently with an age >52 years, the presence of anti-HDV or anti-HCV, alcohol use >4 drinks/day, and a high BMI. The clinical epidemiology of chronic hepatitis B virus (HBV) infection shows a dynamic profile, with the potential for re-emergence of cases with HBeAg or anti-HDV and an emerging impact of metabolic factors on the evolution of liver disease.

Published
2009

21. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study

Author

Bruno, S, Stroffolini, T, Colombo, M, Bollani, S, Benvegnù, L, Mazzella, G, Ascione, A, Santantonio, T, Piccinino, F, Andreone, P, Mangia, A, Gaeta, G, Persico, M, Fagiuoli, S, Almasio, P, Bruno S, Stroffolini T, Colombo M, Bollani S, Benvegnù L, Mazzella G, Ascione A, Santantonio T, Piccinino F, Andreone P, Mangia A, Gaeta GB, Persico M, Fagiuoli S, Almasio PL, Bruno, S, Stroffolini, T, Colombo, M, Bollani, S, Benvegnù, L, Mazzella, G, Ascione, A, Santantonio, T, Piccinino, F, Andreone, P, Mangia, A, Gaeta, G, Persico, M, Fagiuoli, S, Almasio, P, Bruno S, Stroffolini T, Colombo M, Bollani S, Benvegnù L, Mazzella G, Ascione A, Santantonio T, Piccinino F, Andreone P, Mangia A, Gaeta GB, Persico M, Fagiuoli S, and Almasio PL

Abstract

The effect of achieving a sustained virological response (SVR) following interferon-alpha (IFNalpha) treatment on the clinical outcomes of patients with HCV-related cirrhosis is unknown. In an attempt to assess the risk of liver-related complications, HCC and liver-related mortality in patients with cirrhosis according to the response to IFNalpha treatment, a retrospective database was developed including all consecutive patients with HCV-related, histologically proven cirrhosis treated with IFNalpha monotherapy between January 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24 weeks after IFNalpha discontinuation. HCC was assessed by ultrasound every 6 months. Independent predictors of all outcomes were assessed by Cox regression analysis. Of 920 patients, 124 (13.5%) were classified as achieving a SVR. During a mean follow-up of 96.1 months (range: 6-167) the incidence rates per 100 person-years of liver-related complications, HCC and liver-related death were 0, 0.66, and 0.19 among SVR and 1.88, 2.10, and 1.44 among non-SVR (P<0.001 by log-rank test). Multivariate analyses found that non-SVR was associated with a higher risk of liver-related complications (hazard ratio, HR, not applicable), HCC (HR 2.59; 95% CI 1.13-5.97) and liver-related mortality (HR 6.97; 95% CI 1.71-28.42) as compared to SVR. CONCLUSION: Thus, in patients with HCV-related, histologically proven cirrhosis, achievement of a SVR after IFNalpha therapy was associated with a reduction of liver-related mortality lowering both the risk of complications and HCC development. Irrespective of SVR achievement, all patients should continue surveillance because the risk of occurrence of HCC was not entirely avoided.

Published
2007

24. Anti-HCV IgG avidity index in acute hepatitis C

Author

COPPOLA, Nicola, Pisapia R, Marrocco C, Martini S, Vatiero LM, Messina V, Tonziello G, SAGNELLI, Caterina, FILIPPINI, Pietro, Piccinino F, Sagnelli E., Coppola, Nicola, Pisapia, R, Marrocco, C, Martini, S, Vatiero, Lm, Messina, V, Tonziello, G, Sagnelli, Caterina, Filippini, Pietro, Piccinino, F, and Sagnelli, E.

Published
2007

27. Virologial and clinical aspect of occult HBV infection in patient with chronic hepatitis C: a multicentre study

Author

Sagnelli E, Piai G, Cimmino L, Giorgio A, Del Vecchio Blanco C, Messina V, Piccinino F, COPPOLA, Nicola, Marrocco C, Imparato M, Pisapia R, SAGNELLI, Caterina, Filippini P., Sagnelli, E, Piai, G, Cimmino, L, Giorgio, A, Del Vecchio Blanco, C, Messina, V, Piccinino, F, Coppola, Nicola, Marrocco, C, Imparato, M, Pisapia, R, Sagnelli, Caterina, and Filippini, P.

Published
2006

28. Expert Consensus Conference - The screening for hepatitis C virus infection in adults in Italy, May 5-6, 2005

Author

Pagliaro, L, Bianco, E, Mariano, A, Mele, A, Sagliocca, L, Amoroso, P, Ascione, A, Brunetto, M, D'Amico, G, Franco, E, Gaeta, GB, Persico, M, Petrosillo, N, Romano, L, Smedille, A, Stroffolini, T, Taliani, G, Tine, F, Addis, A, Almasio, P, Andreone, P, Andriulli, A, Angelico, M, Savino, B, Coppola, R, Craxi, A, De Masi, S, Fargion, S, Fattovich, G, Gardini, I, Gasbarrini, G, Grieco, A, Levrero, M, Magrini, N, Masutti, F, Pendino, G, Piccinino, F, Pietrangelo, A, Pisani, G, Prati, D, Puccetti, L, Rapicetta, M, Sagnelli, E, Satolli, R, Toti, M, Velati, C, Villa, E, Vitiello, E, Pietrangelo, A., CAPORASO, NICOLA, MORISCO, FILOMENA, Pagliaro, L, Bianco, E, Mariano, A, Mele, A, Sagliocca, L, Amoroso, P, Ascione, A, Brunetto, M, D'Amico, G, Franco, E, Gaeta, Gb, Persico, M, Petrosillo, N, Romano, L, Smedille, A, Stroffolini, T, Taliani, G, Tine, F, Addis, A, Almasio, P, Andreone, P, Andriulli, A, Angelico, M, Savino, B, Caporaso, Nicola, Coppola, R, Craxi, A, De Masi, S, Fargion, S, Fattovich, G, Gardini, I, Gasbarrini, G, Grieco, A, Levrero, M, Magrini, N, Masutti, F, Morisco, Filomena, Pendino, G, Piccinino, F, Pietrangelo, A, Pisani, G, Prati, D, Puccetti, L, Rapicetta, M, Sagnelli, E, Satolli, R, Toti, M, Velati, C, Villa, E, Vitiello, E, and Pietrangelo, A.

Published
2006

30. An attempt to improve classification of HCV-correlated chronic hepatitis

Author

Pasquale G, Sagnelli E, Coppola N, Onofrio M, Scarano F, Scolastico C, Pf, Bellomo, Lettieri A, Ar, Mogavero, Caprio N, Sagnelli C, Piccinino F, Pasquale, Giuseppe, Sagnelli, E, Coppola, Nicola, Onofrio, M, Scarano, F, Scolastico, C, Bellomo, Pf, Lettieri, A, Mogavero, Ar, Caprio, N, Sagnelli, Caterina, and Piccinino, F.

Published
2005

31. Influence of chronic HBV-HCV concurrent infection on liver histology

Author

SAGNELLI E, PASQUALE G, SCARANO F, MARROCCO C, SCOLASTICO C, SANTANTONIO T, GENTILE A, PICCININO F., COPPOLA, Nicola, Sagnelli, E, Pasquale, G, Coppola, Nicola, Scarano, F, Marrocco, C, Scolastico, C, Santantonio, T, Gentile, A, and Piccinino, F.

Published
2004

32. Trattamento della Epatite da HCV

Author

Alberti A, Bonino F, Bortolotti F, Colombo M, Craxì A, Mele A, Rizzetto M, Almasio P, Androne P, Ascione A, Benvegnù L, Brunetto M, Bruno S, Cammaà C, Di Marco V, Fattovich G, Ferrari C, Ideo G, Levriero M, Pagliaro L, Pastore G, Piccinino F, Pontisso P, Puoti C, Puoti M, Raimondo G, Rumi MG, Saracco G, Santantonio T, Smedile A, Zignego L., BRILLANTI, STEFANO, MAZZELLA, GIUSEPPE, Alberti A, Bonino F, Bortolotti F, Colombo M, Craxì A, Mele A, Rizzetto M, Almasio P, Androne P, Ascione A, Benvegnù L, Brillanti S, Brunetto M, Bruno S, Cammaà C, Di Marco V, Fattovich G, Ferrari C, Ideo G, Levriero M, Mazzella G, Pagliaro L, Pastore G, Piccinino F, Pontisso P, Puoti C, Puoti M, Raimondo G, Rumi MG, Saracco G, Santantonio T, Smedile A, and Zignego L.

Subjects
TERAPIA, HCV, EPATITE
Published
2004

33. [Virological and clinical aspects of multiple hepatitis virus infections: preliminary data of an italian multicentre study]

Author

Evangelista Sagnelli, Coppola N, Scolastico C, Filippini P, Piccinino F, Sagnelli, E, Coppola, Nicola, Scolastico, C, Filippini, Pietro, and Piccinino, F.

Abstract

To evaluate the interference between HBV, HCV and HDV and the clinical impact of coinfection as compared with single HBV or HCV infection, we unrolled 618 HBsAg and/or anti-HCV positive subjects (337 with liver biopsy and 281 without liver biopsy) at their first observation at one of the seven Italian Liver Units from 1993 to 1997 (Padova, Rome, Sassari, Naples, Bari, Messina, Palermo). Serum HBV-DNA by dot-blot was found more frequently in patients with HBV infection alone (52% of 133 cases) than in those with HBV-HCV coinfection (28% of 64 cases, p0.005) or in those with HBV-HDV-HCV coinfection (12% of 25 cases, p0.0005) or with HBV-HDV coinfection (13% of 8 cases, p0.05). We observed a higher prevalence of HCV-RNA positive cases in the patients with HCV infection alone (91.2% of 114 cases) than in those with HBV-HCV coinfection (64.5% of 62 cases, p0.0001) or with HBV-HDV-HCV infection (19% of 21 cases, p0.0001). These observations suggest a reciprocal inhibition of HBV and HCV genome in multiple hepatitis viral infection. A severe liver disease was more frequently observed in patients with HBV-HCV coinfection (66%) than in those with a single HBV infection (43%, p0.05) or HCV infection (46%, p0.05). Anti-HCV positive/anti-HBc positive patients, lacking both HBsAg and anti-HBs, compared with the anti-HCV positive/anti HBc negative ones, more frequently showed severe clinical presentation and less frequently had a sustained response to a-IFN treatment.

Published
2003

34. Uselessness of liver biopsy in patients with hepatitis C virus chronic infection and persistently normal aminotransferase levels

Author

Giuseppe Pasquale, Sagnelli, E., Coppola, N., Scarano, F., Scolastico, C., Sagnelli, C., Bellomo, P. F., Lettieri, A., Filippini, P., Piccinino, F., Pasquale, G, Sagnelli, E, Coppola, Nicola, Scarano, F, Scolastico, C, Sagnelli, Caterina, Bellomo, Pf, Lettieri, A, Filippini, Pietro, and Piccinino, F.

Subjects
Adult, Male, Adolescent, Liver, Biopsy, Case-Control Studies, Humans, Female, Hepatitis C, Chronic, Middle Aged, Transaminases, Aged
Abstract

This case-control study evaluated the real need for liver biopsy in subjects with persistently normal aminotransferase values over a long period by comparing the histological features of these subjects with those of patients with abnormal aminotransferase values. We considered as "Cases" all 32 consecutive anti-HCV/HCV-RNA positive subjects with at least eight normal serum ALT values during the last twelve months; for each "Case", we selected as a "Control" one anti-HCV/HCV-RNA positive patient with at least two abnormal serum ALT values during the last twelve months. The Cases and Controls were matched for age ( 5 years) and sex. In the Case group, 1 subject showed normal liver tissue, 18 minimal chronic hepatitis (CH) and 13 mild CH. In the Control group, 7 subjects showed minimal CH, 19 mild CH, 3 moderate CH, 1 severe CH and 2 cirrhosis. The subjects in the Control group showed a significantly higher HAI score (5.39+2.81) than those in the Case group (2.96+1.62, p0.001). The subjects in the Control group more frequently showed a fibrosis score greater than 1 (28.1%) compared to the Case group (9.4%; p0.05). Finally, steatosis was more frequent and more severe in the Control group than in the Case group (respectively, 78.1% vs 50%, p0.05; and 1.47+1.16 vs 0.6+0.71, p0.001). The HAI and fibrosis scores did not correlate with the ALT value, HCV genotype or HCV viral load in either the Case or Control group. Our findings showed that the subjects with a persistently normal serum ALT value had minimal or mild chronic hepatitis, thus demonstrating that a liver biopsy is not indicated for these subjects.

Published
2003

40. Premature discontinuation of interferon plus ribavirin for adverse effects; a multicenter survey in the real world patients with chronic hepatitis C

Author

GAETA, Giovanni Battista, PRECONE DF, FELACO FM, BRUNO R, SPADARO A, STORNAIUOLO G, STANZIONE M, ASCIONE T, DE SENA R, CAMPANONE A, FILICE C, PICCININO F., Gaeta, Giovanni Battista, Precone, Df, Felaco, Fm, Bruno, R, Spadaro, A, Stornaiuolo, G, Stanzione, M, Ascione, T, DE SENA, R, Campanone, A, Filice, C, and Piccinino, F.

Published
2002

41. Kaletra treatment in patients from a Neapolitan area who failed previous HAARTs

Author

Filippini P, Scolastico C, Nacca C, Battaglia M, Rossi G, Scarano F, Onofrio M, D’Aniello F, Pisapia R, Marrocco C, Imparato M, Sagnelli E, Piccinino F., COPPOLA, Nicola, Filippini, P, Scolastico, C, Nacca, C, Battaglia, M, Coppola, Nicola, Rossi, G, Scarano, F, Onofrio, M, D’Aniello, F, Pisapia, R, Marrocco, C, Imparato, M, Sagnelli, E, and Piccinino, F.

Published
2002

44. Infestazioni da Metazoi

Author

PICCININO F, SAGNELLI E, PICCININO R., PASQUALE, Giuseppe, TEODORI U, Piccinino, F, Pasquale, Giuseppe, Sagnelli, E, and Piccinino, R.

Published
2001

45. Malattie endemiche nelle aree tropicali

Author

PICCININO F, SAGNELLI E, PICCININO R., PASQUALE, Giuseppe, TEODORI, Piccinino, F, Pasquale, Giuseppe, Sagnelli, E, and Piccinino, R.

Published
2001

49. Retrospective, observational, multicentre study on an Italian population affected by chronic hepatitis C who failed to clear HCV-RNA after the combined therapy (PEG-IFN and ribavirin): NADIR study

Author

Morisco, F, Stroffolini, T, Medda, E, Amoruso, Dc, Almasio, Pl, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, NADIR Study Group, Aceti, A, Amaddeo, G, Ancarani, F, Arcuri, P, Attili, A, Bandiera, F, Bellati, G, Benigno, R, Benini, F, Bombardieri, G, Bruno, S, Capretti, A, Carrara, M, Cottone, C, Cozzolongo, R, Demelia, L, Di Gaetano, G, Esposito, P, Fanelli, G, Gaeta, Gb, Giannini, Eg, Giorgini, A, Grieco, A, Guadagnino, V, Lanzini, A, Lo Bello, S, Lupo, S, Maracci, M, Marchi, S, Martines, D, Mazzella, G, Miele, L, Milan, M, Milani, S, Minoli, G, Montalto, G, Morrone, A, Nosotti, L, Paroli, M, Pastore, G, Persico, Marcello, Piccinino, F, Pinzello, Gb, Pozzi, M, Roffi, L, Russello, M, Russo, M, Sagnelli, E, Savarino, V, Soccorsi, F, Squadrito, G, Tabone, M, Tarsetti, F, Tesini, Em, Testa, R, Tripi, S, Gianfranca, S, Vandelli, C, Zignego, A. L., Morisco, F., Stroffolini, T., Medda, E., Amoruso, D. C., Almasio, P. L., Villa, E., Zuin, M., Paris, B., Stanzione, M., Caporaso, N., Nadir Study Group, Mazzella, Giuseppe, Morisco, F, Stroffolini, T, Medda, E, Amoruso, DC, Almasio, PL, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, Montalto, G, Morisco, Filomena, T., Stroffolini, E., Medda, D. C., Amoruso, P. L., Almasio, E., Villa, M., Zuin, B., Pari, M., Stanzione, and Caporaso, Nicola

Subjects
Adult, Male, non-responders, relapser, Genotype, body mass index, cirrhosis, hepatitis c virus, nonresponder, pegylated-interferon, Infectious Disease, Hepacivirus, virus, Interferon alpha-2, Antiviral Agents, Polyethylene Glycol, Polyethylene Glycols, Medication Adherence, hepatitis C, Risk Factors, Retrospective Studie, Virology, Ribavirin, Humans, Age Factor, Treatment Failure, Retrospective Studies, Aged, Antiviral Agent, Settore MED/12 - Gastroenterologia, HCV, Antiviral therapy, Body mass index, Cirrhosis, Hepatitis C virus, Nonresponder, Pegylated-interferon, Relapser, Cirrhosi, Hepaciviru, Hepatology, Risk Factor, Age Factors, Interferon-alpha, Hepatitis C, Chronic, Middle Aged, Recombinant Protein, Recombinant Proteins, Italy, RNA, Viral, Female, Hepatitis C viru, Human
Abstract

There is a lack of information on the characteristics of patients with chronic hepatitis C virus infection (HCV) who fail to respond to antiviral treatment. We studied HCV-positive subjects with chronic liver diseases treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) who failed to clear HCV in routine clinical practice. A total of 2150 consecutive adult patients treated with PEG-IFN plus RBV therapy in 46 Italian centres between 1 July 2004, and 30 June 2005, were studied. Of the 2150 patients, 923 (42.9%) (M/F 585/335, mean age 54.8 years) failed to achieve a serum HCV-RNA clearance. Of these 923 patients, 429 (46.5%) were nonresponders, 298 (32.3%) relapsers, 168 (18.2%) drop-outs for noncompliance or adverse events and 28 (3.0%) were lost during follow-up. Overall, 642 (70.6%) patients received adequate therapy (defined as more than 80% of the drug doses for >80% of the time). Genotypes 1-4 were observed in 76.9% of cases; genotypes 2-3 in 21.2% and mixed in 1.9%, respectively. Multiple logistic regression analysis identified genotypes 1 and 4 as the sole independent predictors of the likelihood of nonresponse to therapy compared with relapse (OR: 4.38; 95% CI = 2.28-8.4). Age older than 65 years was the sole independent factor associated with no adherence to therapy (OR: 2.22; 95% CI = 1.36-3.62). Patients who fail to respond to treatment are a nonhomogeneous population with different features, and the sole factor that discriminates nonresponse from relapse is the distribution of genotypes 1-4. Co-morbidities are unable to determine the type of treatment failure and inadequate adherence to therapy mostly affects patients older than 65 years of age. © 2009 Blackwell Publishing Ltd.

Published
2010

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