In vitro-induced antibody production in chronic hepatitis C virus infection

The objectives of the present study were to assess the in vitro-induced anti-hepatitis C virus (HCV) antibody production (IVIAP) in relation to the clinical, biochemical, virologic and histologic variables of patients with HCV infection. The study included 57 patients (60 percent males) with HCV infection (anti-HCV and HCV-RNA positive). Alanine aminotransferase (ALT) was elevated in 89 percent of the patients. Mean viral load was 542,241 copies/ml and histology of the liver showed chronic hepatitis in 27/52 (52 percent) and cirrhosis in 11/52 (21 percent) patients. IVIAP levels were determined by immunoenzymatic assay at median absorbance of 0.781 at 450 nm. IVIAP was negative in 14 percent of the patients. When groups with IVIAP levels above and below the median were compared, high IVIAP levels were associated with the male sex, elevated ALT levels and more advanced disease stage. After logistic regression analysis, advanced histologic damage to the liver remained as the only independent variable associated with elevated IVIAP levels. Using a receiver operator characteristic curve, the best cut-off level for IVIAP was established (= 1.540), with 71 percent sensitivity and 94 percent specificity for the detection of more advanced disease stages (grades 3 and 4). These findings are consistent with the participation of immunological mechanisms in the genesis of the hepatic lesions induced by HCV and indicate that the IVIAP test may be useful as a noninvasive marker of liver damage either alone or in combination with other markers

Phyllanthus amarus no tratamento da infecçäo crônica pelo vírus da hepatite B: crença ou realidade? / Phyllantus amarus in the treatment of chronic infection caused by the hepatitis B virus: belief or reality?

Estudos recentes têm demostrado eficácia do extrato de um vegetal, o Phyllanthus amarus, no tratamento dos portadores crônicos do vírus da hepatite B. Por tratar-se de substância facilmente encontrada em nosso meio e pela ausência de publicaçöes sobre seu uso para esta virose, na literatura nacional, revisäo do assunto foi realizada. Entretanto, os bons resultados referidos nao têm sido repetidos por alguns pesquisadores e, até o momento, a análise dos dados disponíveis revela controvérsias. Falhas metodológicas nesses protocolos, seja com respeito aos critérios de inclusäo, seja na discussäo dos resultados, poderiam explicar a situaçäo do problema. Conclui-se que novos estudos deveräo ser conduzidos, até que se possa estabelecer o real papel do Phyllanthus amarus no tratamento dos portadores crônicos do vírus de hepatite B.