P. Ruello

A Meta‐Analysis of Interferon‐α Treatment of Hepatitis D Virus Infection

The severity of chronic hepatitis D infection and its unfavorable progress necessitate research into drugs and protocols capable of changing the natural history of the disease. Over the last few years interferon (IFN)‐α has been the drug of choice in the management of this infection. We assessed its long‐term efficacy by analyzing 5 controlled and 10 uncontrolled trials conducted between 1987 and 1994. The Mantel‐Haenszel‐Peto method was used in the former to perform statistical analysis. The odds ratio (0.16, confidence interval 0.058‐0.476) confirmed the efficacy of IFN‐α, even if the coefficient was not significant because of the limited number of spontaneous remissions in the trials. Although IFN treatment is fully beneficial in only a small number of patients with chronic hepatitis D infection, at present it is the only available agent.

Lipoprotein(a) Concentration in Patients with Chronic Active Hepatitis C Before and After Interferon Treatment

Patients with chronic active hepatitis C show low lipoprotein(a) (Lp[a]) values. We studied the changes in Lp(a) levels caused by treatment with interferon in 24 patients (9 men and 15 women; mean age, 56.8 +/- 7.3 years) affected by chronic active hepatitis C. Fifteen healthy subjects (6 men and 9 women; mean age, 57.4 +/- 10.3 years) were used as controls. All of the patients with chronic hepatitis C were treated with intramuscular interferon, 3 million units 3 times per week for 6 months. These patients had lower baseline serum Lp(a) concentrations than the controls (4.8 +/- 3.8 mg/dL vs 13.4 +/- 10.3 mg/dL, respectively; P = 0.0007). A significant increase in Lp(a) levels (6.6 +/- 7.2 mg/dL; P = 0.05) occurred after 6 months of treatment in patients with chronic active hepatitis C. Only complete responders presented a significant increase in Lp(a) values (P = 0.01). We believe that increased Lp(a) levels represent an expression of improved liver functions.

Treatment of familial hypertriglyceridaemia with acarbose.

Aim: The evaluation of serum triglyceride levels has played an important role as an independent method for assessing the risk factor for coronary atherosclerosis. Fibrates, nicotinic acid, and omega‐3 polyunsaturated fish oils are the pharmacological tools most used today against hypertriglyceridaemia. Acarbose is a pseudotetrasaccharide of microbial origin which exerts a competitive, selective and reversible inhibition of the intestinal α glucoside‐hydrolase. We evaluated the efficacy and side‐effects of acarbose as a new and alternative drug in the treatment of hypertriglyceridaemia in non‐diabetic patients.

Effect of Interferon on Blood Lipids

SummaryInterferons (IFNs) modify lipid metabolism, increasing triglyceride levels and partially reducing cholesterol values. We studied 25 patients (10 males and 15 females; mean age 56.92 ± 7.16 years) with HCV-Ab-positive chronic active hepatitis, who were treated with IFNα, in order to evaluate their serum lipid behaviour during treatment. We also enrolled 25 healthy controls (10 males and 15 females; mean age 51.12 ± 15.34 years) to compare their lipid profiles with those of the patients. The following parameters were determined prior to and after the 6 months’ treatment: alanine aminotransferase, total cholesterol, high density lipoprotein cholesterol (HDL-C), triglycerides, low density lipoprotein cholesterol (LDL-C), apoprotein A1 (apo A1), apoprotein B100 (apo B100), apo B100/apo A1, total cholesterol/HDL-C, LDL-C/HDL-C ratios, and lipoprotein (a) [Lp(a)]. After the 6-month treatment, there was a decrease in total cholesterol, HDL-C, LDL-C and apo A1, while there was a rise in apo B100, apo B100/apo A1, total cholesterol/HDL-C and LDL-C/HDL-C ratios. There was a significant increase in triglyceride levels and Lp(a) concentrations. The increase in total cholesterol/HDL-C and LDL-C/HDL-C ratios, Lp(a) and triglycerides may enhance cardiovascular risk, thus underlining the need for accurate pre- and intratreatment evaluation in patients on IFN therapy.

LIPOPROTEIN(a) LEVELS IN CENTENARIANS

In elderly subjects (above 65 years), cardio- and cerebrovascular diseases are known to contribute to the death rate. Serum lipoprotein(a) = Lp(a), a low density lipoprotein, is involved in the atherogenic processes, as confirmed by several clinical trials. We evaluated serum Lp(a) levels in a group of centenarians (15 females and 7 males, mean age 102.81 +/- 2.5 years) compared to 25 healthy control subjects (10 males and 15 females, mean age 51.12 +/- 15.34 years). In all subjects Lp(a) serum levels were determined by ELISA method (EIA mod. 2550 reader). Statistical analysis of the results was performed by using the Students t test. In centenarians the mean Lp(a) level increased (39.6 +/- 23.53 mg/dl) compared to that of the control group (16.78 +/- 16.24 mg/dl) (p < 0.005). The elevated Lp(a) values observed in centenarians may be attributed to the presence of low molecular weight lipoprotein isoforms which are known to be associated with cardio-cerebrovascular risk. Therefore, it seems that elevated Lp(a) levels alone are not risk factors for the onset of acute acute vascular accidents and do not influence longevity.

Lipid Profile in Centenarians

SummaryIn human epidemiological studies the levels of plasma lipids are related to the incidence of atherosclerotic cardiovascular disease. In this study we evaluated and compared lipid profiles in a group of healthy centenarians and a control group of adults. The study included 22 healthy centenarians (mean age 102.81 ± 2.5 years) and a control group of 20 elderly volunteers (mean age 70.35 ± 4.12 years). Total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglycerides were determined by enzymatic methods in all subjects. Low-density lipoprotein cholesterol (LDLC) was determined according to Friede wald’s formula; apolipoproteins A and B (Apo A and B) were determined using the nephelometric method, while lipoprotein (a) [Lp(a)] was determined by the ELISA method. The following ratios, which are considered indices of cardiovascular risk, were calculated: TC/HDLC; LDLC/HDLC; Apo B/Apo A. The lipid profile in centenarians was characterised by a lower total cholesterol level (4.36 ± 0.93 mmol/L), LDLC (974.1 ± 288 mg/L), triglycerides (1.14 ± 0.51 g/L), Apo B (0.92 ± 0.26 g/L), Apo B/Apo A ratio (0.63 ±0.1), TC/HDLC ratio (3.52 ± 0.77), and LDLC/HDLC ratio (2.04 ± 0.66) than that observed in controls. Conversely, Lp(a) [39.04 ± 13.44 mg/dl], HDLC (483.1 ± 73 mg/L) and Apo A (1.47 ± 0.28 g/L) were greater in centenarians than in controls.