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Biomedical subjects

D Ouzan

Publications and source records attributed to D Ouzan.

70 records · Page 4Linked to original sources
PubMed1986

Therapeutic activity of vidarabine in symptomatic chronic active hepatitis related to HBV.

The potential inhibitory effects of nucleoside analogues such as ARA-A and acyclovir on HBV-DNA-polymerase were first demonstrated in vitro and then confirmed in vivo in open dose finding studies. The therapeutic efficacy of both ARA-A and ARA-AMP which appeared the most potent drugs was then confirmed by various studies in symptomatic HBeAg-positive patients. These studies demonstrated a similar benefit of therapy with 38 and 40% of treated patients given ARA-A and ARA-AMP, respectively, who permanently cleared HBV replication after a single course, and 67-80% who did so after two courses. Significant improvement in transaminases and histologic activity was also documented (P less than 0.001). Myalgias were observed in 10 and 30% of the patients, respectively. Patients who failed to respond to nucleosides, and those coinfected with HDV, were treated with interferons. Out of 8 cases of HDV/CAH given 5 MU thrice weekly of fibroblast beta-interferon (UPSA) for 3 months, DNA-p activity fell transiently in all 6 initially elevated cases. A parallel decrease in anti-HD titers (P less than or equal to 0.05), inflammation (P less than or equal to 0.001) and necrosis (P less than or equal to 0.05) were observed. alpha-Recombinant interferon was given i.m. for 4 months (2-7 MU/m2 X 2/7 days) to 10 CAH with high DNA-p values. HBV replication was permanently inhibited in 4 cases and dramatically reduced in 3 additional patients. Three failed to respond. Careful monitoring of DNA-p values appeared to be the single most important factor in assessing activity.

Clinical Trials as Topic↗
PubMed1986

Pharmacokinetics of isoxicam in hepatic disease.

1 The pharmacokinetics of single and repeated oral doses of isoxicam, an extensively metabolized drug, were studied in patients with compensated and decompensated hepatic disease. 2 After a single oral dose, isoxicam was slowly absorbed and eliminated (half-life ranging from 10.5 to 53.9 h). Its pharmacokinetics did not differ from those observed in healthy volunteers and were not significantly influenced by the severity of hepatic disease. However, the t1/2 of isoxicam was found to be inversely (r = -0.700, P less than 0.05 n = 14) related to the log gamma-glutamyl transpeptidase plasma activity. 3 During chronic oral treatment in patients with compensated hepatic insufficiency, steady-state was achieved after 7-9 days of therapy. The mean elimination half-life of isoxicam in five patients was 42.6 +/- 4.5 h, a value which was not statistically different from that obtained in the single dose study. 4 It was concluded that patients with hepatic insufficiency do not require a systematic modification of drug dosage but that long-term treatment should be employed with caution in these patients.

Adult↗
PubMed1986

[Viral replication and hepatic manifestations in 7 cases of periarteritis nodosa associated with hepatitis B virus].

Viral replication was studied in 7 cases of PAN associated with hepatitis B virus (HBV). Serum and liver were strongly positive for markers reflecting HBV replication (constant high levels of HBe Ag, numerous hepatocytes nuclei reactive for HBc Ag, high DNA-polymerase activity). No cases were found to be positive for delta antigen or antibody. Mild biological and histological signs of liver damage were present in all patients but one. In PAN, high replication might lead to continuous stimulation and formation of circulating immune complexes in antigen excess which deposit in vascular walls with subsequent vasculitis. The demonstration of intense and permanent HBV replication could explain the unsatisfactory results observed with steroids and immunosuppressive drugs. Since steroids have been shown to increase HBV replication, this therapy might contribute to the perpetuation of the immunopathogenic process responsible for PAN. A more rational approach should take advantage of new antiviral drugs inhibiting HBV replication as suggested by preliminary beneficial results.

Adolescent↗
PubMed1986

[Plasma exchange and acyclovir in Behçet's disease].

It has been postulated that Behçet's disease may be a viral induced vasculitis. In the present study plasma exchanges were applied in an attempt to remove circulating immune complexes and restore cellular immunity. High doses of acyclovir were administered in association with plasma exchanges since it has been shown that herpes simplex virus type 1 might be involved in Behçet's vasculitis. Seven patients with severe ocular manifestations of Behçet's disease were selected for the study. Plasma exchanges were carried out at the rate of 3 per week during 3 weeks and then once every two weeks during 3 months followed by 1 per month during 3 months. 45 mg/day/kg acyclovir were administered intravenously for 21 days. At the end of the follow-up period comparative analysis of panretinal fluorescein angiographies before and after treatment showed no change of the fundus lesions in 3 patients, improvement in only 2 patients and significant worsening in 2 patients. The rather negative results of the present trial lead to assume that HSV-1 is not the virus involved, if any, in Behçet's disease. On the other hand, in the present study, the efficiency of plasma exchanges was transient.

Acyclovir↗
PubMed1983

[Apparently primary malignant secreting renal lymphoma (immunocytoma)].

The authors report a case of renal lymphoma which secreted a monoclonal Ig M kappa immunoglobulin (immunocytoma) and which was diagnosed on the basis of its secretion. They analyse the problems posed by the indication for surgery, the histological nature, the management and the prognosis.

Aged↗
PubMedDate not supplied

[Influence of HIV infection on hepatitis B virus infection in homosexual patients].

Clinical expression and outcome of hepatis B virus infections associated with human immunodeficiency virus infection (without AIDS) were studied in 17 homosexuals during 23 months. In an attempt to distinguish the respective impacts of homosexuality from that of human immuno-deficiency virus, patient were compared with a population of homosexual males infected by hepatitis B virus alone. The ratio of biochemical evidence of liver cell necrosis (ALAT)/viral replication (DNAp) was significatively decreased (p less than 0.01), despite evidence of severe histological damage in some cases. Two-thirds of patients with HBV replication tolerated HBV infection at the end of follow-up. This tolerance was significatively more common than in homosexuals infected by HBV alone (p less than 0.01), and did not appear to be related to decreased T4 cell count but seemed to correlate with the existence of the AIDS related complex.

Adult↗
PubMedDate not supplied

[Vidarabine treatment of chronic active hepatitis associated with hepatitis B virus multiplication. A randomized multicenter study].

A randomized controlled study of one course of vidarabin was carried out in 30 patients with HBs Ag, HBe Ag, DNAp, positive chronic active hepatitis: 15 patients were treated with vidarabin given intravenously (15 mg/kg/day for 7 days then 7.5 mg/kg/day for 14 days); the other 15 patients received a placebo for 21 days. During treatment, DNA polymerase activity fell dramatically in 13 treated patients and in no controls (p less than 0.001). Six months after inclusion, ALT normalization was observed in 40 p. 100 of the treated patients and 6 p. 100 of the controls (p less than 0.05), a decrease in inflammatory activity on liver biopsies was observed in 70 p. 100 of the treated patients and 20 p. 100 of the controls (p less than 0.05), a permanent lost of DNA polymerase and of HBe Ag occurred in 33 p. 100 and 13 p. 100 of the treated patients and 20 p. 100 and 7 p. 100 of the controls, respectively. In addition, a second course of vidarabin was administered to the 12 patients who were still HBe Ag positive 6 months after the first course. During the next 6 months, 8 patients lost DNA polymerase and 4 lost HBe Ag. Altogether, the final score of durable inhibition of HBV replication was 11/15 (73 p. 100) within one year. The above results demonstrate that one course of vidarabin can significantly improve ALT and liver inflammatory activity but the effect upon HBV replication is only transient. A second course does however increase efficacy on HBV replication without additional side effects.

Adult↗