فهرست مطالب

Hepatitis Monthly
Volume:5 Issue: 3, Autumn 2005

  • تاریخ انتشار: 1384/06/20
  • تعداد عناوین: 7
|
  • Alavian Sm Page 51
  • Alavian Sm Page 53
    Case Presentation
    A 25 year-old man referred to our center with symptoms compatible with acute hepatitis for the past two weeks. He was a government employee and had married two months before. We evaluated his lab test and while we were waiting for his lab test result, he called us to say that his wife had the same symptoms. We visited her and found that the clinical picture was compatible with the acute hepatitis, too. It was really interesting for us to see acute presentation in a husband and his wife simultaneously. We asked them about important risk factors like history of transfusion, recent surgery, tattooing, and addiction, all of which were negative. They mentioned that they had a trip to Karbala in Iraq one month before. Afterwards, we received their lab data showing: ALT and AST more than 10 times of upper limit of normal range, elevation in direct bilirubin, HBsAg negative, HBcAb IgM negative, HCV Ab by Eliza test negative and HAV Ab IgM positive. During follow up, fortunately, the symptoms and signs improved and they lived happily ever after! The question is: "should we consider the trip to Iraq a risk factor for acquiring acute HAV infection?"
  • Zeuzem S., Pawlotsky Jm, Lukasiewicz E., Wagner Mv, Goulis I., Lurie Y., Gianfranco E., Vrolijk Jm, Esteban Ji, Hezode C., Lagging, Negro F., Soulier A., Hart Ev, Hansen B., Tal R., Ferrari C., Schalm Sw, Neumann Au Page 57
    Background And Aims
    The aim of this study was to increase virologic response rates by individualized treatment according to the early virologic response.
    Methods
    Serum HCV-RNA was frequently quantified in patients with chronic hepatitis C (n=270) treated with peginterferon alfa-2a (180 µg/week) and ribavirin (1000-1200 mg/day). After 6 weeks patients were classified as rapid (RVR), slow (SPR), flat (FPR), or null responders (NUR) and randomized within each viral kinetic class to continue therapy either with an individualized or standard regimen. Individualized therapy comprised peginterferon monotherapy (48 weeks) or shorter combination therapy (24 weeks) for RVR, triple therapy with histamine (1 mg/day) (48 weeks) or prolonged combination therapy (72 weeks) for SPR, triple therapy for FPR, and high-dose peginterferon (360 µg/week) plus ribavirin for NUR patients.
    Results
    Patients were categorized as RVR (n=171), SPR (n=65), FPR (n=10), or NUR (n=22). Overall end-of-treatment and sustained virologic response rates were 77 and 60% in the individualized and 77 and 66% in the standard treatment arm, respectively. Histamine in addition to peginterferon and ribavirin and highdose peginterferon plus ribavirin did not improve virologic response rates in patients with FPR and NUR, respectively.
    Conclusions
    An improvement in virologic efficacy was not achieved with the available individualized treatment options.
  • Somi Mh Page 65
  • Ahmadipour Mh, Alavian Sm, Amini S., Azadmanesh K Page 77
  • Soheili Z., Samiei S Page 83
  • Page 89