Background: There are few data on the use of the C-13-aminopyrine breath test to evaluate the severity of disease in patients with hepatitis C virus-related chronic liver disease, although these patients represent one...
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Background: There are few data on the use of the C-13-aminopyrine breath test to evaluate the severity of disease in patients with hepatitis C virus-related chronic liver disease, although these patients represent one of the most important problems in clinical hepatology. Aims: To compare C-13-aminopyrine breath test results of patients with hepatitis C virus-related chronic hepatitis and Child-Pugh class A cirrhosis with those of normal subjects, and to evaluate different methods of expressing C-13-aminopyrine breath test results. Methods: Twenty-four patients with hepatitis C virus-related chronic hepatitis and 17 patients with Child-Pugh class A cirrhosis underwent C-13-aminopyrine breath test. Breath samples were collected every 30 min up to 2 h after C-13-aminopyrine administration. C-13-Aminopyrine breath test results were expressed as a percentage of the administered dose of C-13 recovered per hour (% dose/h) and the cumulative percentage of administered dose of C-13 recovered Over time (% dose cum). Nineteen healthy subjects served as controls. Patients with hepatitis C virus-related chronic hepatitis were divided into subgroups on the basis of histological staging and grading. Results: The C-13-aminopyrine breath test result (% dose/h) at 30 min was significantly different among the three subgroups of subjects (normal subjects, 11.5+/-3.5: chronic hepatitis patients. 8.1+/-4.1;cirrhosis patients, 5.0+/-3.1: P<0.0005). Moreover, the differences between chronic hepatitis and cirrhosis patients were statistically significant (P<0.03). The fibrosis score showed a significant inverse correlation with the C-13-aminopyrine breath test result (% dose/h) at 30 min (r(s) = -0.409, P=0.05). The C-13-aminopyrine breath test result (% dose/h) at 30 min also allowed normal subjects and chronic hepatitis patients with low (less than or equal to2) or high (> 2) fibrosis scores to be distinguished. The C-13-aminopyrine breath test results (% dose cum) at 30, 60 and 90 min a
OBJECTIVE: Proton pump inhibitors and antimicrobial agents are widely used to eradicate Helicobacter pylori (H. pylori) infection. In the general population the prevalence of infection and of polypharmacy increases th...
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OBJECTIVE: Proton pump inhibitors and antimicrobial agents are widely used to eradicate Helicobacter pylori (H. pylori) infection. In the general population the prevalence of infection and of polypharmacy increases the possibility of drug-drug interactions during H. pylori eradication therapy. The purpose of the present study was to assess the prevalence, degree, and clinical relevance of metabolic interference with the cytochrome P450 enzymatic system occurring during 1 wk of administration of omeprazole, lansoprazole, or pantoprazole followed by the association of clarithromycin and metronidazole for another week. The C-13 aminopyrine breath test (ABT) was chosen to screen for possible interactions. METHODS: We studied 30 patients referred to our Unit for H. pylori eradication therapy. They were randomized to receive either omeprazole (20 mg b.i.d.), lansoprazole (30 mg b.i.d.), or pantoprazole (40 mg b.i.d.) for 2 wk. During the second week clarithromycin (250 mg b.i.d.) and metronidazole (500 mg b.i.d.) were added. ABT was performed before, and at the end of the first and second week of therapy. Percentage of the administered dose of C-13 recovered per hour at the peak (percent C-13 dose/h at the peak) and cumulative percentage of administered dose of C-13 recovered over time at 120 min (percent C-13 dose cum(120)) were the ABT evaluated parameters. RESULTS: At baseline all patients showed a normal liver function. In individual patients during treatment we observed various liver metabolic interactions both as inhibition and induction, as well as after the first and the second week of therapy. However, mean modifications of the ABT parameters during the 2 weeks of therapy were not statistically significant compared to baseline values. None of the patients who had ABT variations complained of side effects. CONCLUSIONS: H. pylori eradication therapy interferes with cytochrome P450-dependent liver metabolic activity. However, the clinical relevance of these metaboli
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