A. De Gottardi

Critical review of the use of erythropoietin in the treatment of anaemia during therapy for chronic hepatitis C

Summary.  Combined pegylated interferon (PegIFN) and ribavirin represents the standard therapy for patients with chronic hepatitis C (CHC), which allows for sustained viral response (SVR) in up to 90% of patients depending on certain viral and host factors. Clinical studies have demonstrated the importance of adherence to therapy, that is, the ability of patients to tolerate and sustain a fully dosed therapy regimen. Adherence is markedly impaired by treatment‐related adverse effects. In particular, haemolytic anaemia often requires dose reduction or termination of ribavirin treatment, which compromises treatment efficacy. Recent evidence points to a beneficial role of recombinant erythropoietin (EPO) in alleviating ribavirin‐induced anaemia thereby improving quality of life, enabling higher ribavirin dosage and consequently improving SVR. However, no general consensus exists regarding the use of EPO for specific indications: its optimal dosing, treatment benefits and potential risks or cost efficiency. The Swiss Association for the Study of the Liver (SASL) has therefore organized an expert meeting to critically review and discuss the current evidence and to phrase recommendations for clinical practice. A consensus was reached recommending the use of EPO for patients infected with viral genotype 1 developing significant anaemia below 100 g/L haemoglobin and a haematocrit of <30% during standard therapy to improve quality of life and sustain optimal ribavirin dose. However, the evidence supporting its use in patients with pre‐existing anaemia, non‐1 viral genotypes, a former relapse or nonresponse, liver transplant recipients and cardiovascular or pulmonary disease is considered insufficient.

19 DARK CHOCOLATE ATTENUATES THE POST-PRANDIAL INCREASE IN HVPG IN PATIENTS WITH CIRRHOSIS AND PORTAL HYPERTENSION

were observed between PH-S and PH-P. According to response to propranolol prophylaxis status, and ADRB2 polymorphisms (SNP) a significant higher ADRB2 activity was observed in non-responder PH patients. This activity was more pronounced when any of the ADRB2 SNP was present in both, responder and non-responder patients (Fig. 1). Conclusions: Non-responder PH patients to propranolol prophylaxis show a most reactive ADRB2 to adrenergic stimulus compared with responders, in both groups, native or polymorphic patients.

P523 SAFETY AND EFFICACY OF AN AUTOMATED LOW FLOW ASCITES (ALFA) PUMP IN CIRRHOTIC PATIENTS WITH REFRACTORY ASCITES

P522 TOTAL SERUM BILE ACIDS IN PATIENTS WITH HEPATOPULMONARY SYNDROME T. Horvatits, A. Drolz, C. Muller, G. Fauler, P. Schenk, M. Trauner, V. Fuhrmann. Dep. Internal Medicine, Div. of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria E-mail: thomas.horvatits@meduniwien.ac.at