METHODS

This study covered 93 naive patients of CHB and hepatitis-B carriers with a history of 1.4 ± 1.0 years. All the subjects and their parents agreed to participate in the study after full explanation of the nature and purpose of the investigation. CHB was diagnosed by clinical, biochemical and serological methods. The patients with transaminase values exceeding 1.5 times and with a high level of HBV-DNA were determined as CHB. Liver biopsy was performed on 22/50 CHB patients. We determined hepatocellular damage of varying degrees in the biopsy of 22 patients (16 mild, four intermediate, two severe). The mean Knodell score was 5.77 ± 1.23. For the patients who had a HBsAg positive, no clinical signs of liver disease and no elevated ALT values were determined as the HBV carrier.

The other indicators of viral hepatitis (anti-HCV, anti-Delta, anti-HAV IgM) and anti-HIV were negative in patients accepted into the study. The patients had not used any drug pertaining to hepatitis or any other disease previously. When you need your medication buy canadian pharmacy cialis

The patients were divided into three treatment groups based on age, gender, etiology and HBeAg positivity. These groups were as follows: levamisole group (L: N=32 patients), vaccine group (V: N=28 patients), and combined levamisole and vaccine group (LV: N=33 patients). Levamisole (Ketrax®) was delivered to the L group as 2.5 mg/kg (p.o.) three times a week. HBsAg vaccine (Gen Hevac B®) was administered to the V group subcutaneously in doses of 20-, 30- and 40 |ug at one-month intervals. Both drugs were delivered to the LV group. No side effects were observed during the treatment period. Your life is worth living. Buy levitra canadian pharmacy online

Pretreatment and three-month-long posttreatment ALT values and indicators of hepatitis В were studied. Serum ALT analysis was studied using an Olympus AU 800 autoanalyzer with its own kits. Values above 45 U/L were assessed as being high. HBV antigen and antibodies, HAV-IgM, anti-HCV and anti-HDV tests were performed in a full automatic ELISA device with BIOKIT kits and, by SFRI

ALPHA 4, Spain. The HBV-DNA was analyzed with a microcolon DNA probe RIA (Abbot) and Quan-tiplex branched DNA by Bayer Diagnostics, Emeryville, CA. The results were expressed as pg/ml. Viagra Professional 100 mg

RESULTS

Fifty-eight (62%) of all patients were male and 35 (38%) female; the age range was 10.4 ± 4.38 years. The mean etiology variation was 1.4 ± 1.0 years. Pre-treatment conditions and virological indicators are shown in Table 1. Despite the high pre-treatment ALT values, after application of the treatment to 50 patients, the ALT values of 15 (30%) patients were normal. The distribution of these patients over the various groups was as follows: L: seven patients, V: four patients and LV: four patients. In nine patients, the ALT values were found to be higher than the pre-treatment values (L: three patients, V: two patients and LV: four patients). In six patients (10%), HBV-DNA loss was observed (L: one patient, V: two patients and LV: three patients). Before the study, average HBV-DNA levels were 597.62 ± 99.60 pg/ml and the posttreatment mean value was 1,591.87 ± 265.31 pg/ml. With the exception of one patient from each group, HBV-DNA levels were found to be higher than the pretreatment values in all of the CHB patients. Before the treatment, there were 50 HBeAg-positive patients. After the treatment, however, in 17 (34%) of these patients HBeAg proved to be negative. The HBeAg loss according to the groups was as follows: L: seven patients, V: three patients and LV: seven patients. HBeAg sero-conversion was observed in 10 (20%) cases distributed as follows: L: two patients, V: three patients and LV: five patients. After the treatment, loss of HBsAg and HBsAg sero-conversion were observed in two patients (2.1%). One of the patients was in group L and the other in group V, and both were carriers of hepatitis B. Posttreatment conditions and virological indicators are shown in Table 2. In CHB patients, the decrease of ALT and the HBV-DNA rise were significant (Table 3). Rosiglitazone medication

Table 1. Characteristics of patient groups before treatment

Groups

L (N=32)

V (N=28)

LV (N=33)

Age (year)

10.15 ±4.84

10.93 ±4.19

10.20 ±4.38

Gender (male/female)

17/15

18/10

23/10

Duration of illness (year)

1.56 ± 0.98

1.66 ± 1.28

1.26 ± 1.02

CHB/HBVC

17/15

15/13

18/15

Liver biopsy

17/6

15/7

18/9

Knodell (average)

6.2 ± 1.64

4.57 ± 2.44

6.70 ± 4.8

ALT (IU/L)
<45

15

13

15

>45

17

15

18

HBeAg (+)

19/32

13/28

18/33

HBV-DNA negativity

10/32

11/28

9/33

HBV-DNA positivity

22/32

17/28

24/33

HBV-DNA(pg/ml)

621 ± 196.52

727 ±219.21

675 ± 194.85

L: levamisole; V: vaccine; LV: levamisole plus vaccine; CHB: chronic hepatitis B; HBVC: hepatitis-B virus carrier

Table 2. ALT and hepatitis В virological indications after treatment

Groups

L (N=32)

V (N=28)

LV(N=33) Total (N=93)
ALT decrease

7

4

4

15/50 (30%)

ALT increase со

2

4

9/50 (18%)

HBsAg sero-conversion

1

0

1

2/93 (2%)

HBeAg loss

7/19

3/13

7/18

17/50 (34%)

HBeAg sero-conversion

2

3

5

10/50 (20%)

HBV DNA loss

1

2

3

6/63 (10%)

HBV DNA decrease

1

1

1

3/63 (5%)

HBV DNA increase

20

14

20

54/63 (85%)

Table 3. ALT and HBV-DNA values of chronic hepatitis-B patients before and after therapy

Number of Patients Before Therapy After Therapy
ALT (IU/L)

50

89.03 68.49 PO.05
HBV-DNA (pg/ml)

63

610.50 1,580.21 PO.05

Statistical Methods
For the dependent groups, the Wilcoxon matched pairs test and for the independent groups the Mann-Whitney U test were used in evaluation of the parameters. The analyses were assessed using the SPSS 6.0 for Windows® program.

Category: Diseases / Tags: hepatitis В, levamisole therapy, vaccine therapy

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