thought this might interest some

[alley-oops]

54th Annual Meeting of the American Association
for the Study of Liver Diseases
 October 24 - 28, 2003, Boston, MA  

Can Improved Nutritional Status of Patients Improve the Success Rate of Treatment with Interferon Alfa and Ribavirin?

Interferon (IFN) alfa-2b/ribavirin therapy is an effective antiviral therapy for the patients with hepatitis C virus (HCV) genotype 1. However, the response to this therapy is not satisfactory because only about 40-50% of the patients become sustained responders (SR). Further, patients receiving IFN alfa-2b/ribavirin therapy have frequently withdrawn from studies because of severe adverse effects.

The efficacy of IFN therapy is mediated by both genomic type and viral load and to immunological response of the hosts. Reportedly, some amino acids modulate the host's immunological response. In order to achieve a higher SR ratio after IFN alfa-2b/ribavirin therapy and to decrease the number of patients who withdraw, it seemsimportant to improve the nutritional condition and to up-regurate potential immunological response by modifying the balance of amino acids.

In the present study, we investigated the dynamics of a panel of 41 amino acids during IFN alfa-2b/ribavirin therapy, and then analyzed the effects of nutrition on the clearance of HCV.


Seventy patients with chronic HCV infection were included after informed consent. Six million units of IFN alfa-2b in combination with ribavirin (600-800mg/day) were given over 6 months. During the first 2 weeks of the therapy, IFN alfa-2b was given daily. Blood samples were obtained after overnight fasting at 2weeks, 8 weeks, and 24 weeks of therapy and served as the analysis of amino acids. At the same time, peripheral blood mononuclear cells (PBMC) were collected and the numbers of IFNγ- and IL4-producing cells were measured by FACS analysis. Th1/Th2 ratio was calculated as follows: Th1/Th2=IFNγ-producing cells (%)/IL4-producing cells (%).

Study Results

HCV RNA became undetectable in 22%, 52%, and 78% of the patients at weeks 2, 8, and 24 of therapy, respectively. Th1/Th2 ratio decreased gradually during therapy. Th1/Th2 ratio at the end of therapy (24 weeks) was significantly smaller than that at the beginning. (17.8±10.9 vs 13.5±8.0, p=0.011). However, there was no significant correlation of Th1/Th2 level with the rate of HCV eradication.

Total amino acids (TAAs) and branched chain amino acids (BCAAs) decreased gradually during therapy. Even at 8 weeks of therapy, there was a significant decrease in TAA and BCAA (p=0.017 and p<0.0001, respectively). Fischer ratio (FR) also showed dramatic change. It changed from 2.83 (at the beginning of the therapy) to 2.19 (at 8 weeks of therapy), indicating that the balance of amino acids rapidly changed to the condition similar to the patients with liver cirrhosis.

Of interest, the levels of TAA and BCAA at the beginning of the therapy were significantly higher in the HCV RNA-negative group than in the HCV RNA-positive group at the end of therapy (TAA: 3243±275 vs 2877±252 nmol/ml; p=0.004, BCAA: 470±92 vs 377±65 nmol/ml; p=0.024).

Although we could not find a significant difference, FR at the beginning of the therapy was larger in HCV RNA-negative group than in HCV RNA-positive group at the end of therapy (2.81±0.51 vs 2.47±0.68, p=0.15).

Analysis of each amino acids showed that there were significant differences in the concentration of citrulline and ornithine, both amino acids are involved in urea cycle, between HCV RNA-negative and HCV RNA-positive group at the end of therapy.

Conclusions

Interferon alfa-2b/ribavirin therapy induces malnutrition in the early stage of therapy. Successful elimination of HCV RNA seemed to depend more on nutrition rather than on the ratio of Th1/Th2 during therapy, suggesting that a better response to interferon alfa-2b/ribavirin therapy might be possible by improving the nutritional status of the patients at the beginning of therapy. In addition, adequate nutrition support would contribute to the improvement of QOL of the patients, which would lead to a decrease in patient withdrawals during interferon alfa-2b/ribavirin therapy.

12/08/03

[Jackie]

Thanks Alley. That was very informitive and makes alot of sense.

How are you doing? Shot 27 tonight. Where does the time go?

[alley-oops]

Hey Jackie,
I thought you guys might like that extra info, every little bit helps, eh? Especially with the holiday season with all those tempting sweets and naughty chocolates.   I'm doing so very well thanks for asking. I am thrilled that you are already on #27, rounding the corner I hope.
alley

[Penney]

Hi guys!
Thanks for the info Alley  Just got my 24 week viral count......still 'undetectable' !!  

Gonna beat this.............

Take care,
Penney

[sands3]

Alley, does this mean  watch what you eat?
And congrats Penny on the undetectable. I do an RAI in the morning for the thryoid and a scan in the afternoon then a follow up the next day. Then Doc will look at the TSH levels and prescribe new meds in Jan. just in time for the Feb. appointment with the Endo to discuss beggining treatment again for the HCV. Count our blessings.

If God brings you to it, He will bring you through it.

Happy moments, praise God.
Difficult moments, seek God.
Quiet moments, worship God.
Painful moments, trust God.
Every moment, thank God.

[alley-oops]

yes it does mean to treat your diet with respect because it could make a difference. maybe look at supplimenting diets with amino acids.
Alley

[Al]

Ok Alley, I guess "Twinkies" aren't part of the better nutrition regiman? Are "Ding-Dongs" & "Ho-Ho's" cool?

[alley-oops]

Oh Al, Who am I to take away your twinkies?  I would have to be a ding dong to deny you your naughty  treats. I hope you are not a ho ho pimp.

[Al]

Alley,

Who you be callin' a "ho" pimp? I iz a legit, discrete bidnez man~ You gots da need? I can feed.....

[alley-oops]

I'm just a twinkie, Al, I ain't acusing you of nothin".
alley

[Al]

You be wantin' some "ho'ho's" then? Nice & fresh? Wrapped in cellophane at da peak of their choclatey freshness?

[alley-oops]

Al, You know I luv ya but no matter how fresh and good you make those HoHo's sound I am into alternative foods and I don't eat prefab foods. Thanks for trying though, makes me feel strong to say NO thanks.  
Alley

[willy]

Hi;  My name is willy and I'm trying to "get clean".  Hi WILLY!!  I've been cutting back on the white sugars and some of my Christmas candy.  I've got to say however; Ho Ho's are not the monkey on my back.  First of all, the cellophane wrapper is redundant.  The parafine that they add to the "chocolate" seves the same purpose.  I've always wondered why the cockroaches* pass on certain foods; think they may know something that we don't?  On the health food pyramid....ho ho's are right up there with Shell No Pest Strips.  

On a similar vein, as a public service anouncement to those of us that are busy, on TX and in a fog, or domestically "challenged".  It's new years eve.  Any food that's been in your fridge for more than a year this might be the time to pitch it.  If you don't get around to doing that......make a mental note to get another box of baking soda.   There! All better!

Willy
*thingyroaches is a word that is imposed by YABB on my posting of a word that contains a portion of a "banned" word.  The spanish equivalent is la cucharacha.  You know the bug; roaches.  This last section is a "modification" I added.

[Al]

I checked my food pyramid. Neither ho ho's or shell no pest strips were listed. Perhaps mine is out of date?

Thanks for the tip Willy. The Shell No Pest Strips are delicious!

[alley-oops]

Al Al Al I worry about you, you are one kooky puppy.
Happy New Year!!!!!! ( Look at my posting time!!!) Hey The computer is lying it's 3 minutes past midnight!!!