Serum Alpha-fetoprotein Levels and Response to Direct Antiviral Therapy in Patients with Chronic Hepatitis C: Real-world Results from 1716 Patients in Egypt

2019 ◽  
Vol 19 (7) ◽  
pp. 1005-1011
Author(s):  
Rehab Badawi ◽  
Mohamed Alboraie ◽  
Sherief Abd-Elsalam ◽  
Mohamed Z. Abourahma ◽  
Haidi K. Ramadan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
Multivariate Logistic Regression Analysis ◽  
P Value ◽  
Significant Variable ◽  
Chronic Hcv

Background &Aims: Direct Antiretroviral Agents (DAAs), sofosbuvir-based therapies, have opened a new era in the treatment of chronic HCV infection. The aim of the study was to investigate the potential use of baseline and in serial serum, AFP levels as a predictor for response to DAAs in patients with Chronic Hepatitis C. Methods: This multicenter observational study was carried out on 1716 chronic hepatitis C virusinfected patients who received direct anti-viral drugs for 12 weeks. The primary end point was sustained virological response at 12 weeks after the end of treatment determined by quantitative PCR for HCV RNA. Serum AFP was quantitatively assessed at baseline then after 12week after stoppage of treatment (SVR12). Results: SVR12 rate was 97.8%. Elevated serum AFP was significantly higher in non -SVR group p value (<0.001). There was a significantly marked decrease in AFP after treatment in comparison to pretreatment values. The multivariate logistic regression analysis on the resulting significant variable from the univariate analysis revealed that only AFP was significantly related to the response to direct antiviral therapy in patients with chronic hepatitis C with p <0.001, OR 1.10 (95% CI 1.07:1.12). Other sociodemographic (e.g. Age, gender, BMI, ..) or laboratory factors (Hb, ANC, WBCs, …) did not show any significant association with the patients’ response to treatment. Conclusion: Serum AFP levels were a predictor for response in patients with chronic HCV with the administration of direct antiviral drugs.

scholarly journals Liver Impairment and Hematological Changes in Patients with Chronic Hepatitis C and COVID-19: A Retrospective Study after One Year of Pandemic

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 597
Author(s):  
Bianca Cerbu ◽  
Stelian Pantea ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Clinical Outcomes ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Multivariate Logistic Regression Model ◽  
P Value ◽  
Liver Impairment ◽  
All Cause Mortality ◽  
Chronic Hcv

Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients with chronic diseases are at greater risk for complications and poor outcomes. The objective of this study was to investigate the liver function abnormalities and clinical outcomes in patients with COVID-19 and chronic hepatitis C. Materials and Methods: This retrospective, single-center study was conducted on a cohort of 126 patients with a history of hepatitis C, confirmed with COVID-19 between 01 April 2020 and 30 December 2020. Several clinical outcomes were compared between patients with active and non-active HCV infection, and the risks of liver impairment and all-cause mortality in active HCV patients were analyzed using a multivariate logistic regression model. Results: Among 1057 patients under follow-up for chronic HCV infection, 126 (11.9%) were confirmed with COVID-19; of these, 95 (75.4%) were under treatment or achieved SVR, while in the other 31 (24.6%), we found active HCV replication. There was a significantly higher proportion of severe COVID-19 cases in the active HCV group as compared to the non-active HCV group (32.2 vs. 7.3%, p < 0.001). Multivariate analysis showed that age, sex, alanine aminotransferase, C-reactive protein, procalcitonin, and HCV viral load were significant independent risk factors for liver impairment and all-cause mortality. The length of stay in hospital and intensive care unit for COVID-19 was significantly higher in patients with active HCV infection (p-value < 0.001), and a higher proportion of these patients required mechanical ventilation. Conclusions: Active HCV infection is an independent risk factor for all-cause mortality in COVID-19 patients.

scholarly journals Significance of iron reduction for the therapy of chronic hepatitis C

2005 ◽  
Vol 62 (2) ◽  
pp. 161-164 ◽  
Author(s):  
Darko Nozic ◽  
Bela Balint ◽  
Nebojsa Stankovic ◽  
Jovan Dimitrijevic ◽  
Gorana Neskovic
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Iron Overload ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Iron Reduction ◽  
Elevated Serum ◽  
Chronic Viral Hepatitis ◽  
Viral Hepatitis C ◽  
Iron Deposits

Background. It has been established that many patients with chronic hepatitis C have elevated serum iron, feritin levels and iron deposits in the liver. Therefore, the liver damage due to hepatitis C virus may be aggravated with iron overload. In many studies higher levels of iron in the blood and the liver were connected with the decreased response to interferon-alfa therapy for chronic viral hepatitis C. Recent introduction of pegylated interferons plus ribavirin has improved the therapeutic response, so it is now possible to cure more than 50% of the patients. Case report. Three patients with chronic hepatitis C and iron overload were presented. Iron reduction therapy using phlebotomy or eritrocytapheresis with plasmapheresis was done at different times in regard to specific antiviral therapy or as a sole therapy. Conclusion. It has been shown that iron reduction, sole or combined with antiviral therapy, led to the deacreased aminotransferase serum activity and might have slow down the evolution of chronic hepatitis C viral infection.

scholarly journals Predictive Clinical Value of Rheumatoid Factor and Anti-Citrullinated Protein Antibodies as Diagnostic Tools in Cases with Non-Arthritic Chronic Hepatitis C Viral Disease

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Rheumatoid Factor ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
P Value ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Antibody Levels ◽  
Citrullinated Protein

Background: Rheumatoid arthritis is a chronic immunological disease that causes destruction and deformity of joints. Chronic hepatitis C infection cases could develop rheumatic like clinical presenting profile. Raised rheumatoid factor in chronic HCV infection considerably reduces the diagnostic privilege of rheumatoid factor for rheumatoid arthritis coexisting with HCV infection. Aim of the work: To determine the value of anti-citrullinated protein antibody levels in cases having chronic HCV infection in comparison to rheumatoid factor. Methodology: The research team recruited 150 non-arthritic study subjects having chronic hepatitis C virus infection rheumatoid factor and anti-citrullinated protein antibody levels were assayed for all study subjects for statistical analysis. Results: Rheumatoid factor +ve study subjects had statistically significantly more frequent within female gender. (p value=0.027) Rheumatoid factor high +ve cases had statistically significantly had more frequent fatty liver and higher platelets than on high RF +ve cases. (P value =0.020, <0.038 consecutively) Conclusion: HCV cases with joint involvement were not implemented in the current research study that prevented statistical estimation of the sensitivity of anti-citrullinated protein antibody for arthritis in this cohort. Racial and ethnic differences should be put in consideration in future research studies that are recommended to be multi centric in fashion.

Barriers to Treatment of Chronic Hepatitis C with Direct Acting Antivirals in an Urban Clinic

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Miguel H. Malespin ◽  
Ciel Harris ◽  
Ozdemir Kanar ◽  
Kelly Jackman ◽  
Carmen Smotherman ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Treatment Initiation ◽  
Barriers To Treatment ◽  
Academic Practice ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Urban Clinic

Introduction and Aim. Direct-acting antiviral (DAA) agents are highly effective for treatment of chronic hepatitis C virus (HCV) yet access to treatment remains a serious challenge. The aim of this study was to identify barriers to treatment initiation with DAA-containing regimens in an urban clinic setting. Materials and Methods. A retrospective cohort of all chronic HCV patients seen in an urban academic practice in Jacksonville, FL, USA from 1/2014-1/2017 was analyzed. Baseline characteristics were recorded and a review of medical records was performed to identify barriers to treatment initiation and overall success rates. Results. Two-hundred and forty patients with chronic HCV were analyzed. Fifty-six percent of patients were African-American and 63% were insured through Medicaid/county programs or uninsured. Sixty-nine percent had barriers to initiating antiviral therapy categorized as psychosocial (n=112), provider (n=26), medical (n=20), and insurance-related factors (n=7). The most commonly encountered psychosocial barriers included failure to keep appointments (79/240, 33%), active substance abuse (18/240, 8%), and failure to obtain laboratory testing (11/240, 5%). Overall, only 27% of patients evaluated were initiated on DAA-containing regimens with 18% reaching SVR12 within the 36-month study period. Conclusion. In conclusion, only 27% of patients who presented to an urban academic practice with chronic HCV received DAA-containing regimens over a 36-month period. Psychosocial issues were the major barriers to antiviral therapy. These findings illustrate the need for an integrated approach that addresses psychosocial factors as well as comorbidities and adherence to care in order to increase rates of HCV treatment in at risk patients.

Fibrosis scoring has significant impact on the outcome of antiviral therapy for chronic hepatitis C

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
A Qasim ◽  
A Grogan ◽  
B Hynes ◽  
H Irish ◽  
D Kevans ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C

Genetic polymorphisms as the predictors of response to antiviral treatment in chronic hepatitis C virus infection

2011 ◽  
Vol 152 (22) ◽  
pp. 876-881
Author(s):  
Alajos Pár
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Genetic Polymorphisms ◽  
Chronic Hepatitis C ◽  
Genome Wide Association Study ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
Snp Analysis ◽  
Chronic Hcv

The review discusses the genetic polymorphisms involved in the pathogenesis of hepatitis C virus (HCV) infection, that may determine the outcome of disease. In this field earlier both certain major histocompatibility complex (MHC) alleles and some cytokine gene variants have also been studied. Recently, the genome-wide association study (GWAS) and targeted single nucleotide polymorphism (SNP) analysis have revealed that a variant in the promoter region of interleukin-28B (IL-28B) gene is strongly linked to viral clearance and it may be the strongest pretreatment predictor of treatment response in chronic hepatitis C. Last year it was shown that two genetic variants leading to inosine triphosphatase deficiency protect against haemolytic anemia in patients receiving ribavirin during antiviral treatment for chronic HCV infection. Orv. Hetil., 2011, 152, 876–881.

Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment

2016 ◽  
Vol 18 (2) ◽  
pp. 155-165 ◽  
Author(s):  
Axel C. Mühlbacher ◽  
John F. P. Bridges ◽  
Susanne Bethge ◽  
Ch.-Markos Dintsios ◽  
Anja Schwalm ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment
Sign in / Sign up

Export Citation Format

Share Document