RESUMEN
Three doses of a recombinant DNA HBV vaccine (MSD) were given to healthy male homosexuals. Seventy-eight out of 104 (77.6%) participants had detectable antibody (anti-HBs) two months after the third dose. Seroconversion occurred in only 9 out of 27 subjects (33.3%) who were anti-HIV positive compared with 69 out of 77 (89.6%) who were negative (chi 2 = 30.8; P less than .001). Fifteen of the 18 anti-HIV positive who did not mount an antibody response to the hepatitis B vaccine (anti-HBs) later progressed to persistent generalised lymphadenopathy syndrome (5), AIDS-related complex (5), and AIDS (5). Only one of the nine anti-HIV positive anti-HBs responders developed PGL (chi 2 = 10.14; P less than .005). Our results show that anti-HIV positive homosexuals are poor responders to the recombinant hepatitis B vaccine and anti-HIV positive non-responders are more likely to develop clinically apparent HIV infection.
Asunto(s)
Seropositividad para VIH/inmunología , Vacunas contra Hepatitis Viral/inmunología , Estudios de Seguimiento , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B/biosíntesis , Vacunas contra Hepatitis B , Homosexualidad , Humanos , Masculino , Pronóstico , Saccharomyces cerevisiae , Vacunas Sintéticas/inmunologíaAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Hipotensión Ortostática/inducido químicamente , Zidovudina/efectos adversos , Síndrome de Inmunodeficiencia Adquirida/sangre , Método Doble Ciego , Humanos , Hidrocortisona/sangre , Masculino , Persona de Mediana Edad , Zidovudina/sangre , Zidovudina/uso terapéuticoRESUMEN
OBJECTIVE: To determine the effect of low dose interferon alfa (human lymphoblastoid interferon) on aminotransferase activities in chronic non-A non-B hepatitis. DESIGN: Prospective randomised controlled parallel group study of active treatment versus no treatment carried out over 16 weeks and preceded by baseline measurements at weeks 8 and 4 and time zero. SETTING: HEPATOLOGY outpatient clinics in secondary referral centres. PATIENTS: Fourteen adults with histologically proved chronic hepatitis and persistently raised aminotransferase activities for six months or more. INTERVENTIONS: Seven patients randomised to receive interferon alfa 5 megaunits (MU) daily for one week, reducing to 5 MU thrice weekly for seven weeks, then 3 MU thrice weekly for eight weeks. Controls not treated. END POINT: Control of hepatic enzyme activity in chronic non-A non-B hepatitis. MEASUREMENTS AND MAIN RESULTS: Serum aspartate aminotransferase activity remained raised in controls (mean increase in study period 23.4 U/l) but fell rapidly to normal in the treated group (mean decrease 106.4 U/l). In four cases values were normal by eight weeks and in five cases by 16 weeks. Only minor side effects were recorded (fever, myalgia), which became less common as treatment progressed. CONCLUSIONS: Continuous low dose interferon alfa reduces aspartate aminotransferase activity to normal in most patients with chronic non-A non-B hepatitis and may prevent progression to cirrhosis.
Asunto(s)
Hepatitis C/terapia , Hepatitis Viral Humana/terapia , Interferón Tipo I/uso terapéutico , Adulto , Aspartato Aminotransferasas/sangre , Enfermedad Crónica , Ensayos Clínicos como Asunto , Femenino , Hepatitis C/enzimología , Humanos , Interferón Tipo I/administración & dosificación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Distribución Aleatoria , Proteínas RecombinantesRESUMEN
Suramin has recently been shown to inhibit the activity of the duck hepatitis B virus DNA polymerase (DHBV DNAp) in vitro. However, we found no demonstrable in vivo suppression of human hepatitis B virus DNA polymerase (HBV DNAp) activity in three male patients with severe chronic active hepatitis. Suramin treatment resulted in prolongation of the prothrombin time in all cases and a rise in bilirubin in two and it may have led to haemorrhage from oesophageal varices in one patient and to hepatic encephalopathy in another. Its use in chronic hepatitis is not recommended.