ABSTRACT
It has been suggested that the measurement of metronidazole clearance is a sensitive method for evaluating liver function. The aim of this study was to evaluate the usefulness of plasma hydroxy-metronidazole/metronidazole ratios as indicators of dynamic liver function to detect changes resulting from the various forms of chronic hepatitis C virus (HCV) infection. A total of 139 individuals were studied: 14 healthy volunteers, 22 healthy, asymptomatic, consecutive anti-HCV-positive HCV-RNA negative subjects, 81 patients with chronic hepatitis C (49 with moderate/severe chronic hepatitis and 34 with mild hepatitis), and 20 patients with cirrhosis of the liver. HCV status was determined by the polymerase chain reaction. Plasma concentrations of metronidazole and its hydroxy-metabolite were measured by reverse-phase high-performance liquid chromatography with ultraviolet detection in a blood sample collected 10 min after the end of a metronidazole infusion. Anti-HCV-positive HCV-RNA-negative individuals demonstrated a significantly reduced capacity to metabolize intravenously infused metronidazole compared to healthy individuals (0.0478 ± 0.0044 vs 0.0742 ± 0.0232). Liver cirrhosis patients also had a reduced plasma hydroxy-metronidazole/metronidazole ratio when compared to the other groups of anti-HCV-positive individuals (0.0300 ± 0.0032 vs 0.0438 ± 0.0027 (moderate/severe chronic hepatitis) vs 0.0455 ± 0.0026 (mild chronic hepatitis) and vs 0.0478 ± 0.0044 (anti-HCV-positive, HCV-RNA-negative individuals)). These results suggest an impairment of the metronidazole metabolizing system induced by HCV infection that lasts after viral clearance. In those patients with chronic hepatitis C, this impairment is paralleled by progression of the disease to liver cirrhosis.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anti-Infective Agents , Hepacivirus/genetics , Hepatitis C, Chronic/complications , Liver Cirrhosis/diagnosis , Metronidazole , Anti-Infective Agents/blood , Biomarkers/blood , Case-Control Studies , Chromatography, High Pressure Liquid , Genotype , Liver Function Tests , Liver Cirrhosis/etiology , Metronidazole/analogs & derivatives , Metronidazole/blood , Polymerase Chain Reaction , Severity of Illness Index , Viral LoadABSTRACT
O objetivo deste estudo é avaliar a cavidade bucal de pacientes com refluxo gastroesofágico para encontrar lesões nos dentes e nos tecidos lisos e comparar a prevalência dessa lesões com as observadas em pacientes que não apresentaram o refluxo. O estudo incluiu cinquenta e seis pacietes (26 do sexo masculino e 30 do feminino) com média de idade de 40 anos ( faixa de 29 a 60 anos), que foram submetidos a endoscopia superior para avaliar sintomas dispépticos. Trinta pacientes apresentavam esofagite péptica erosiva e foram colocados no grupo I. Verificou-se que vinte e seis pacientes apresentavam dispepsia funcional e estes foram colocados no grupo II. Os dois grupos de pacientes foram submetidos a avaliações bucais por um dentista. Os pacientes com refluxo gastroesofágico tinham maior prevalência de erosões, abrasão e atrito, porém uma prevalência significante mais baixa de cáries e gengivite. A presença de esofagite erosiva não teve impacto sobre a prevalência de periodontite. Ainda será preciso determinar se essa interferência está relacionada com uma maior exposição da placa dentária ao ácido e `a pepsina, devido a uma interferência da função salivária.