Chromosomal analysis of colonic adenomatous polyps.

Chromosomal analysis of 25 colonic adenomatous polyps was performed by a direct method similar to that used in prenatal diagnosis of chromosomal aberration on chorionic villi. Fourteen lesions showed an abnormal karyotype. Two changes were recurrent: trisomy 7 (observed in eight cases) and trisomy 13 (observed in seven cases). No monosomy of the short arm of chromosome 17 was observed even at the level of two polyps with in situ carcinoma lesions.

[Appearance of hepatitis C virus replication and increase of aminotransferase activity after corticoid treatment of presumed autoimmune hepatitis. 2 cases]. / Apparition d'une réplication du virus de l'hépatite C et augmentation de l'activité des aminotransférases après traitement corticoïde d'une hépatite présumée auto-immune. Deux observations.

Autoimmune-related and hepatitis C virus-related chronic hepatitis are sometimes difficult to differentiate. We report two cases of chronic hepatitis with high levels of serum anti-smooth muscle antibodies, positive hepatitis C virus serology, and negative serum RNA, which were first treated with corticotherapy. Both patients responded with marked increases in aminotransferase levels, and positive RNA. The first case may have been type 1 autoimmune hepatitis with hepatitis C virus infection, and the second chronic hepatitis C with positive serum auto-antibodies. The increase in viral antigen expression on the surface of the hepatocytes following corticosteroid treatment may have favoured a direct cytopathogenic effect of hepatitis C virus.

[Omeprazole and liver functions]. / Oméprazole et fonctions hépatiques.

Omeprazole is the first of a new class of drugs (proton pump blockers) approved in the United States and in Europe for its high efficiency as an inhibitor of gastric acid secretion. Omeprazole is a drug for short term use in patients with acid-peptic disease. A limited prevalence of hepatotoxic effects is reported by some authors (transitory rise in serum aminotransferase level) and it may be prescribed in patients with chronic liver disease although slower metabolism and greater bioavailability are observed. Omeprazole interacts with the cytochrome P-450 system in the liver: inhibition of several liver mono-oxygenases activities (inhibitory effect on diazepam, phenytoin and R-warfarin metabolism with prolonged elimination); induction of P-450 (IA1 and IA2) enzymes that may potentiate the hepatotoxic effect of phenacetin and acetaminophen or increase the tumorigenic effect of chemical carcinogens (polycyclic aromatic hydrocarbons, arylamines, aflatoxin). This latter concern is unfounded as based on a false extrapolation from the results of in vitro studies to those of in vivo situations. However, although omeprazole has proved to be remarkably free of side effects, postmarketing surveillance is recommended for potential interaction with other drugs that are known to be metabolized by the same liver enzymes.

[Possible sexual transmission of hepatitis C virus]. / Possibilité de transmission du virus de l'hépatite C par voie sexuelle.

The development of hepatitis C virus (HCV) serology has made it possible to identify high-risk populations. The predominant mode of contamination is parenteral, but the relative frequency of the so-called sporadic hepatitis C cannot be explained in this way, and this raises the question of possible sexual contamination. The risk of HCV being transmitted by sexual intercourse has been studied in 30 couples, each with one infected partner. Among the 30 HCV seropositive subjects, 18 were followed up for chronic hepatitis and 2 for haemophilia; 10 were recruited in sessions of blood donation. The other 30 partners were tested for HCV seropositivity and investigated for other possible risk factors by means of a questionnaire. Three of them had antibodies to HCV, but only one, whose partner had chronic hepatitis, showed no other source of contamination. The prevalence of HCV positivity was 3.3 percent overall and 5.5 percent in the chronic hepatitis group. Thus, the risk of HCV heterosexual contamination is low when compared with that of the other sexually transmitted diseases. However, the prevalence of HCV in this population seems to be 5 to 10 times higher on average than in the general population.

Detection of HCV-RNA in saliva of patients with chronic hepatitis C.

Previous studies have provided conflicting results on the presence of hepatitis C virus-RNA in saliva. In this study, 23 (62%) of 37 patients tested positive for hepatitis C virus-RNA in saliva, using polymerase chain reaction analysis. A slightly greater proportion had a sporadic rather than a parenteral origin of chronic hepatitis C. These results provide a biological basis for saliva as a possible source of hepatitis C virus (HCV) infection, but do not necessarily imply transmission by this route.