Abnormally high resistive index of central retinal artery by ultrasound color Doppler in patients with viral chronic liver disease: correlation with worsening liver staging

Retrobulbar-ocular circulation provides an opportunity to assess the terminal circulation of the arterial cerebral tree. To evaluate whether retrobulbar circulation in patients with chronic liver disease is affected by adaptive mechanisms, we assessed by echo color Doppler, 1. The resistive-index of the central retinal artery, a terminal branch of the ophthalmic artery, and 2. the potential interrelationships with both liver staging and the most important splanchnic Doppler-parameters used to assess portal hypertension. The resistance index (RI) of the central retinal artery was obtained and compared with other classical Doppler parameters known to be affected by portal hypertension. The RI of the central retinal artery (CRA) was higher in cirrhotic patients than in controls or subjects with chronic hepatitis; it correlated with all the Doppler parameters of portal hypertension considered, with plasma renin-activity, and norepinephrine concentrations. Similarly to renal and splanchnic hemodynamics, retinal arterial circulation assessed by duplex Doppler seems to be affected by the histology of liver disease and by the overactivity of vasoconstrictor systems.

Low daily dosage of interferon for 1 year after HCV-related end-therapy response. A randomized-controlled study

This randomized controlled study involved 236 1b genotype (121 males) naive patients with chronic hepatitis C. After a course of interferon (IFN)-alpha2b plus ribavirin for 6 or 12 months, 117 (49.5%) of the end-therapy responders were equally divided into two groups and were assigned to receive either low daily doses of IFN-alpha2b (1.5 MU) 'consolidation therapy' (59 patients) for 1 year or no further treatment (58 patients). At the end of the follow-up period (6 months), the number of sustained responders in the consolidation group (83%) was significantly higher than in the control group (37.9%). The predicting factors of both end-therapy response and sustained response were the classic ones and a lower GGT/ALT ratio (GGT: gamma-glutamyl transpeptidase; ALT: alanine aminotransferase). The strongest predictors of sustained response alone were consolidation therapy and the longer period on combined treatment (12 vs 6 months). Consolidation therapy was better tolerated than the previously prescribed combined therapy in terms of side effects. In conclusion, genotype 1b naive end-therapy responders to usual combined therapy, after a period of daily consolidation therapy with a low dosage of IFN without ribavirin, achieved a better rate of sustained response than the control group.