frequency of non-organ-specific autoantibodies in patients with chronic hepatitis C and its relation with disease severity and response to therapy

Increased levels of non-organ-specific autoantibodies are frequently seen in patients suffering from chronic hepatitis C [CHC]; however, the etiology and its effects on the course of the disease and response to therapy are largely undetermined. Particularly, it seems of utmost importance to define whether this increase is solely an insignificant coincidence or a major finding which have an impact on the course of the disease. Materials and methods: Fifty-two patients with CHC [case group] and 52 aged- and sex-matched IBS patients [controls] were enrolled. The sera of all subjects were checked for non-organ-specific autoantibodies, including antinuclear antibody [ANA], anti-smooth muscle antibody [ASMA], anti-mitochondrial antibody [AMA], and anti-liver/kidney microsomal antibody [ALKM]. All cases underwent a liver biopsy and treated with a 12-month course of combination therapy with interferon and ribavirin. The mean age of cases and controls was 32.8 +/- 12.7 and 31.6 +/- 14.1 years, respectively. The overall frequency of non-organ-specific antibodies was significantly higher in anti-HCV positive patients in comparison with controls [36.5% vs 7.7%, p < 0.001]. Seropositivity of ANA and ASMA was significantly higher in patients with CRC than in controls [11.5% vs. 1.9%, p < 0.05 and 13.5% vs. 1.9%, p < 0.027, respectively]. There was no significant relationship between seropositivity of different autoantibodies and patients' age and sex, duration of disease and serum aminotransferases levels. Nor this seropositivity had significant relationship with grade and stage of the liver disease and response to treatment, while serum globulin level was significantly higher in ANA positive patients. Seroprevalence of ANA and ASMA seems to be higher in patients with CHC but its impact on the severity of disease and response to therapy is the subject for further investigations. Keywords: Hepatitis C, Autoantibody, Response to treatment, Aminotransferases

Comparison of sucralfate and hydrocortisone enemas in treatment of active ulcerative proctitis; a double-blind randomized clinical trial

Sucralfate enema has been proposed and investigated in treatment of ulcerative proctitis, but its efficacy is still a matter of debate. Hydrocortisone enema is still an established drug in treatment of ulcerative proctitis. This study was designed to compare the effect of sucralfate enema with hydrocortisone enema. Patients with active sigmoidoscopic and histologic features of ulcerative proctitis were included. All patients had clinical manifestations of proctitis for at least four weeks prior to the study and had negative parasitic stool culture. The total of 25 patients entered the study. They were randomly divided in two groups; group I [n =14] and group II [n = 11] who received sucralfate and hydrocortisone enemas respectively for 4 weeks. Both groups had a significant improvement in clinical features, histologic activity and sigmoidoscopic evaluation in comparison with the baseline. Furthermore there was no significant differences between the two groups concerning mean changes of clinical, sigmoidoscopic, and histologic grading, after treatment. Considering the low cost and minimal adverse effects of sucralfate, and almost equal efficacy in comparison with hydrocortisone enema, its usage can be recommended