Clinical studyAccelerated decline in lung function and impaired reversibility with salbutamol in asthmatic patients with chronic hepatitis c virus infection: a 6-year follow-up study☆
Section snippets
Methods
Sixty HCV-positive patients with a diagnosis of asthma according to the American Thoracic Society guidelines were recruited for this study (7). We have studied asthmatic patients since 1992 in a region (Osaka City, Japan) that has an extraordinarily high incidence of HCV infection. Pulmonary function tests and responses to bronchodilators (β2-adrenoceptor agonists and anticholinergic agents) were examined regularly in these patients at 1-year intervals. HCV-positive patients were selected
Results
At the start of the study, the three groups of patients with asthma (20 HCV-negative, 18 interferon responders, and 37 interferon nonresponders) had similar age, sex, and baseline lung function (Table 1), although serum aminotransferase levels were significantly lower in HCV-negative patients. One year after interferon therapy, mean (± SD) aminotransferase levels were significantly lower in interferon responders (aspartate aminotransferase: 25 ± 10 U/L; alanine aminotransferase: 22 ± 9 U/L)
Discussion
We found that pre- or postbronchodilator FEV1 at year 6 after interferon therapy was significantly lower in interferon nonresponders than in HCV-negative patients and in interferon responders. Moreover, a steep decline in reversibility with salbutamol occurred only in interferon nonresponders, whereas there was a steep increase in reversibility with oxitropium in those patients. It seems unlikely that interferon therapy directly influenced airway responses to salbutamol or oxitropium apart from
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This work was supported by a Grant-in-Aid for Scientific Research (15590820) from the Japan Society for the Promotion of Science.