Chest
Volume 123, Issue 2, February 2003, Pages 600-603
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Preliminary Reports
Interferon Therapy Induces the Improvement of Lung Function by Inhaled Corticosteroid Therapy in Asthmatic Patients With Chronic Hepatitis C Virus Infection*: A Preliminary Study

https://doi.org/10.1378/chest.123.2.600Get rights and content

Study objectives:

Several reports have suggested that subsets of asthmatic patients with chronic viral infection fail to respond to corticosteroid therapy. Therefore, this study was designed to determine that asthmatic patients with chronic hepatitis C virus (HCV) infection fail to improve lung function by inhaled corticosteroid therapy, and that interferon (IFN) therapy against HCV is effective for such patients.

Design:

Prospective observational study.

Setting:

University hospital.

Patients:

Forty asthmatic patients with chronic HCV infection.

Interventions:

After a 4-week run-in period, all asthmatic patients received therapy with inhaled beclomethasone dipropionate (BDP), 400 μg twice daily for 6 weeks. After the first study, all asthmatic patients continued to receive inhaled BDP, and 30 HCV-positive asthmatic patients received IFN-α therapy for 6 months.

Measurements and results:

Prebronchodilator and postbronchodilator FEV1 values were examined after a 4-week run-in period, after 6 weeks of BDP therapy, and at 1 year from the end of IFN therapy. After a 4-week run-in period as well as after 6 weeks of BDP therapy, there were no significant differences in either prebronchodilator or postbronchodilator FEV1 values among the three groups. However, 1 year after the end of IFN therapy, the mean prebronchodilator and postbronchodilator FEV1 values were significantly higher in the IFN responder group (n = 11) [prebronchodilator FEV1, 1.93 L (SD, 0.13 L); postbronchodilator FEV1, 2.28 L (SD, 0.15 L)] than in the IFN nontreatment group (n = 10) [prebronchodilator FEV1, 1.78 L (SD, 0.10 L); p = 0.01; postbronchodilator FEV1, 2.07 L (0.13 L); p = 0.005] or the IFN nonresponder groups (n = 19) [prebronchodilator FEV1, 1.79 L (SD, 0.15 L); p = 0.006; postbronchodilator FEV1, 2.07 L (SD, 0.18 L); p = 0.002]. Moreover, prebronchodilator and postbronchodilator FEV1 values were significantly higher only in the IFN responder group at 1 year after the end of IFN therapy than after the 4-week run-in period (prebronchodilator FEV1, p = 0.028; postbronchodilator FEV1; p = 0.002) or after 6 weeks of BDP therapy (p = 0.016 and p = 0.004, respectively).

Conclusions:

Our findings suggest that chronic HCV infection in asthmatic patients is associated with impaired responses to inhaled BDP therapy and that intervention with IFN reverses such responses only in the IFN responder group.

Section snippets

Materials and Methods

Forty-eight HCV-positive patients with a diagnosis of asthma according to the American Thoracic Society guidelines9 were recruited into this study. These patients were randomly selected from a region (Osaka City, Japan) with an extraordinarily high incidence of chronic HCV infection. Eight patients were lost during the follow-up period as a result of cardiovascular disease, hepatocellular carcinoma, or transfer to another hospital. Anti-HCV antibody was measured with a first-generation or

Results

The clinical characteristics of the 40 asthmatic patients with chronic HCV infection are shown in Table 1. The three groups were well-matched with respect to age and baseline lung function. However, increased levels of aspartate aminotransferase and alanine aminotransferase were found in all three groups. After the 4-week run-in period, there was no significant difference in either prebronchodilator or postbronchodilator FEV1 values among the three groups. After 6 weeks of BDP therapy, there

Discussion

In this study, we found that inhaled BDP therapy did not significantly improve prebronchodilator and postbronchodilator FEV1 values after 6 weeks of BDP therapy in patients in any of the three groups. However, previous studies have reported1112 that the baseline value of FEV1 after inhaled steroid therapy markedly improved in steroid-naive asthmatic patients. Moreover, prebronchodilator and postbronchodilator FEV1 values were significantly higher 1 year after the end of IFN therapy than after 6

REFERENCES (18)

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This work was supported by a grant-in-aid for Scientific Research (No. 13670611) from the Ministry of Education, Science, and Culture, Japan.

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