PMID- 27070167
OWN - NLM
STAT- MEDLINE
DCOM- 20180827
LR  - 20181202
IS  - 0040-3660 (Print)
IS  - 0040-3660 (Linking)
VI  - 88
IP  - 4
DP  - 2016
TI  - [The efficiency and safety of anti-Helicobacter pylori therapy in patients with 
      concomitant chronic hepatitis C].
PG  - 75-81
LID - 10.17116/terarkh201688475-81 [doi]
AB  - AIM: To evaluate the efficiency and safety of two eradication therapy (ET) 
      regimens for Helicobacter pylori infection in patients with concomitant chronic 
      hepatitis C (CHC) in relation to the stage of liver fibrosis (LF). MATERIALS AND 
      METHODS: A prospective clinical trial was conducted in parallel groups. Group 1 
      included 50 HCV-negative patients with H. pylori-associated peptic ulcer of the 
      stomach or duodenum; Group 2 consisted of 50 HCV-positive patients with H. 
      pylori-associated peptic ulcer of the stomach or duodenum concurrent with CHC. 
      Each group was divided in 2 subgroups according to the used triple ET (a proton 
      pump inhibitor (PPI) in a standard dose + amoxicillin 1000 mg twice daily + 
      clarithromycin 500 mg twice daily for 10 days) or sequential therapy (PPI in a 
      standard dose + amoxicillin 1000 mg twice daily within the first 5 days and then 
      PPI in a standard dose + clarithromycin 500 mg twice daily + metronidazole 500 mg 
      twice daily for the next 5 days). LF was assessed using indirect elastometry. The 
      efficiency of ET was evaluated by a breath test (after 4 weeks) and an analysis 
      depending on intention-to-treat (ITT) and per-protocol (PP) treatments. A 
      patients recorded adverse events in specially developed diaries. RESULTS: The 
      efficiency of ET was 74% (ITT) and 80.4% (PP) in Group 1 and 76 (ITT) and 79.1% 
      (PP) in Group 2. Both groups displayed a tendency towards an 11.9-12.4% increase 
      in the efficiency of the sequential therapy versus the classical triple (PP) one. 
      The rate of totally found side effects was 20% in Group 1 and 28% in Group 2. 
      During sequential therapy, the rate of side effects was lower than that during 
      the classical one. The efficiency of ET did not significantly depend on the stage 
      of LF. Only the presence of concomitant type 2 diabetes mellitus and the use of 
      macrolides (12 months before treatment) significantly lowered the efficiency of 
      ET (OR 0,21; 95% CI 0,06-0,69, p=0,0102 and OR 0,27 95% CI 0,08-0,9, p=0,0342). 
      LF regardless of its magnitude significantly determined the risk of adverse 
      events during ET (OR 3,33 95% CI 1,19-9,31, p=0,0217). A group at the highest 
      risk of adverse events included patients with liver cirrhosis (OR 4,87; 95% CI 
      1,01-23,5, p=0,0492). CONCLUSION: It is appropriate to prescribe a sequential ET 
      regimen as more effective and safe for patients with concomitant CHC during 
      therapy for H. pylori infection-associated diseases. LF increases the risk of 
      adverse events during ET.
FAU - Andreev, D N
AU  - Andreev DN
AD  - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
FAU - Maev, I V
AU  - Maev IV
AD  - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
FAU - Kucheryavyi, Yu A
AU  - Kucheryavyi YA
AD  - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
FAU - Dicheva, D T
AU  - Dicheva DT
AD  - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
FAU - Partsvania-Vinogradova, E V
AU  - Partsvania-Vinogradova EV
AD  - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
LA  - rus
PT  - Journal Article
TT  - Effektivnost' i bezopasnost' antikhelikobakternoi terapii u patsientov s 
      soputstvuyushchim khronicheskim gepatitom S.
PL  - Russia (Federation)
TA  - Ter Arkh
JT  - Terapevticheskii arkhiv
JID - 2984818R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 804826J2HU (Amoxicillin)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - Amoxicillin
MH  - Anti-Bacterial Agents/adverse effects/*therapeutic use
MH  - Clarithromycin
MH  - Diabetes Mellitus, Type 2
MH  - Drug Therapy, Combination
MH  - Helicobacter Infections/complications/*drug therapy
MH  - Helicobacter pylori
MH  - Hepatitis C, Chronic/*complications
MH  - Humans
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/adverse effects/*therapeutic use
MH  - Treatment Outcome
EDAT- 2016/04/14 06:00
MHDA- 2018/08/28 06:00
CRDT- 2016/04/13 06:00
PHST- 2016/04/13 06:00 [entrez]
PHST- 2016/04/14 06:00 [pubmed]
PHST- 2018/08/28 06:00 [medline]
AID - 10.17116/terarkh201688475-81 [doi]
PST - ppublish
SO  - Ter Arkh. 2016;88(4):75-81. doi: 10.17116/terarkh201688475-81.