RESUMO
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a significant health problem for which there is no universally accepted pharmacological treatment. The combination of weight loss and antioxidant drugs to ameliorate insulin resistance and improve steatosis, inflammation and fibrosis provides the rational for therapeutic trials. AIM: To evaluate the efficacy and safety of a nutritional supplement Viusid in association with diet and exercise for NAFLD. METHODS: A randomized, controlled and parallel-group trial was conducted at a tertiary care academic centre (National Institute of Gastroenterology, Havana, Cuba). We randomly assigned 60 patients with liver biopsy-proven NAFLD to 6 months of treatment with a hypocaloric diet plus aerobic exercise daily and three Viusid sachets daily or a hypocaloric diet and exercise. Endpoints were improvement in the NAFLD activity score (NAS), fibrosis and normalization of serum aminotransferase levels. RESULTS: A significant improvement in steatosis, necroinflammation and fibrosis was seen in each group of treatment (P < 0.01 for each feature). The Viusid group, as compared with the control group, significantly reduced the mean of NAS [from 4.18 to 0.54 points in the Viusid group vs. 4.45 to 2.2 points in the control group (P < 0.001)]. On between-group comparison, Viusid was found to be associated with a significantly greater improvement in steatosis (P < 0.001), ballooning (P = 0.002) and lobular inflammation (P = 0.025), but not in fibrosis (P = 0.07). Viusid was well tolerated. CONCLUSIONS: Our results indicate that treatment with diet and exercise leads to a notable improvement in the histological features of NAFLD; however, the administration of Viusid intensifies the improvements of histological findings, especially of steatosis and inflammation.
Assuntos
Suplementos Nutricionais , Terapia por Exercício , Fígado Gorduroso/dietoterapia , Adolescente , Adulto , Idoso , Glicemia/metabolismo , Terapia Combinada/métodos , Cuba , Fígado Gorduroso/sangue , Fígado Gorduroso/patologia , Feminino , Fibrose/terapia , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Transaminases/sangue , Resultado do Tratamento , Adulto JovemRESUMO
Four hundred and sixty one samples randomly selected among blood donors from three blood banks in Havana City were investigated for HCV antibodies. Samples repeatedly reactive to Organcon Tecknica immunoenzymatic assay were considered positives and were further confirmed by an Ortho test. An epidemiological survey was conducted among all donors included in the sample to assess infection risk factors. Seven subjects (1.5%) resulted repeatedly reactive to the test, slightly higher than in developed countries. Mean age in positive patients was seven years higher than in negative subjects (39 vs 31.5), but the Student's test did not show any significant difference. Seropositivity was higher in males (1.7 vs 0.9) and very similar as to the color of skin (1.9 mulattos, 1.5 whites and 1.0 blacks) but it was not statistically significant (p > 0.05). Among risk factors with higher odd ratios were to have more than five sexual partners in the last five years and having worked in a health care institution, but this was not statistically significant (p > 0.05). The probability of receiving one unit of HCV infected blood was of 1.5% and 45% when receiving 40 units. Given the importance of the virus, the need of establishing specific control measures in the shortest period of time for HCV detection in blood is under-lined.