Imperial College London
Portrait Picture

DrNikhilVergis

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Senior Lecturer
 
 
 
//

Contact

 

n.vergis

 
 
//

Location

 

Norfolk PlaceSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Vergis:2016:10.1053/j.gastro.2016.12.019,
author = {Vergis, N and Atkinson, SR and Knapp, S and Maurice, J and Allison, M and Austin, A and Forrest, EH and Masson, S and McCune, A and Patch, D and Ryder, S and Wright, M and Thursz, MR},
doi = {10.1053/j.gastro.2016.12.019},
journal = {Gastroenterology},
pages = {1068--1077.e4},
title = {In patients with severe alcoholic hepatitis, prednisolone increases susceptibility to infection and infection-related mortality, associated with high circulating levels of bacterial DNA},
url = {http://dx.doi.org/10.1053/j.gastro.2016.12.019},
volume = {152},
year = {2016}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND & AIMS: Infections are common in patients with severe alcoholic hepatitis (SAH), but little information is available on how to predict their development or their effects on patients. Prednisolone is advocated for treatment of SAH, but can increase susceptibility to infection. We compared the effects of infection on clinical outcomes of patients treated with and without prednisolone, and identified risk factors for development of infection in SAH. METHODS: We analyzed data from 1092 patients enrolled in a double-blind placebo-controlled trial to evaluate the efficacy of treatment with prednisolone (40 mg daily) or pentoxifylline (400 mg 3 times each day) in patients with SAH. The 2 × 2 factorial design led to 547 patients receiving prednisolone; 546 were treated with pentoxifylline. The trial was conducted in the United Kingdom from January 2011 through February 2014. Data on development of infection were collected at evaluations performed at screening, baseline, weekly during admission, on discharge, and after 90 days. Patients were diagnosed with infection based on published clinical and microbiologic criteria. Risk factors for development of infection and effects on 90-day mortality were evaluated separately in patients treated with prednisolone (n = 547) and patients not treated with prednisolone (n = 545) using logistic regression. Pretreatment blood levels of bacterial DNA (bDNA) were measured in 731 patients. RESULTS: Of the 1092 patients in the study, 135 had an infection at baseline, 251 developed infections during treatment, and 89 patients developed an infection after treatment. There was no association between pentoxifylline therapy and the risk of serious infection (P = .084), infection during treatment (P = .20), or infection after treatment (P = .27). Infections classified as serious were more frequent in patients treated with prednisolone (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.27-2.92
AU  - Vergis,N
AU  - Atkinson,SR
AU  - Knapp,S
AU  - Maurice,J
AU  - Allison,M
AU  - Austin,A
AU  - Forrest,EH
AU  - Masson,S
AU  - McCune,A
AU  - Patch,D
AU  - Ryder,S
AU  - Wright,M
AU  - Thursz,MR
DO  - 10.1053/j.gastro.2016.12.019
EP  - 1077
PY  - 2016///
SN  - 0016-5085
SP  - 1068
TI  - In patients with severe alcoholic hepatitis, prednisolone increases susceptibility to infection and infection-related mortality, associated with high circulating levels of bacterial DNA
T2  - Gastroenterology
UR  - http://dx.doi.org/10.1053/j.gastro.2016.12.019
UR  - https://www.sciencedirect.com/science/article/pii/S0016508516355330?via%3Dihub
UR  - http://hdl.handle.net/10044/1/44797
VL  - 152
ER  -
Download