Treatment of anicteric acute hepatitis C with peginterferon alpha-2a plus ribavirin

Background. Hepatitis C virus (HCV) infection is the most frequent cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma in the world. Acute hepatitis C is the most commonly asymptomatic liver disease with the development of chronic HCV infection in the majority of infected patients. Studies of the natural history of HCV infection suggest that only 15-30% of patients with acute infection recover spontaneously. Others, up to 85% of the infected patients develop chronic hepatitis C. Acute hepatitis C is so uncommon and with the unpredictable occurrence, and of the low frequency, that it is difficult to determine the optimal treatment of this disease. There have been many randomized, controlled trials of the therapy in patients with chronic hepatitis C, but none of an adequate size or rigor in patients with acute hepatitis C. Therefore, the causal treatment of patients with acute hepatitis C aimed at the prevention of chronic liver disease is necessary. Case report. We have treated a patient with anicteric form of acute hepatitis C after a three-month outpatient follow-up using a combined therapy: pegylated interferon-alpha 2a, 180 ?g, subcutaneously, once a week plus ribavirin 1000 mg orally once a day. The treatment lasted 24 weeks. Stable biochemical and virological response was achieved both at the end of the treatment and 6 months after the completion of the therapy. Conclusion. We believe that the above mentioned might be one of the approaches to the treatment of acute hepatitis C. However, further prospective studies with significantly larges number of patients are necessary for the definite conclusions about the treatment of HCV infections.

Download Full-text

Chronic HCV - infection in the Kirov region: Dynamics of indices of disease in adults in 1995-2010

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40712 ◽

2013 ◽

Vol 18 (2) ◽

pp. 33-36

Author(s):

S. V Baramzina

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Acute Hepatitis ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Acute Hepatitis C ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

The Given ◽

Epidemiological Situation

In the given article the analysis of an epidemiological situation concerning chronic forms of HCV infections in adults in the Kirov region in 1995-2010 is presented. In the region during analyzed period stable trend to the elevation of incidence of chronic hepatitis C and a slight decrease in the number of "carriers" of HCV on the background of steadily low indices of the occurrence of acute hepatitis C have been fixed. There are also presented the results of genotyping of HCV-virus in 730 patients with chronic hepatitis C treated at the Kirov Region infectious hospital and polyclinics in Kirov with the dominance of HCV subtypes 1b and 3a .

Download Full-text

Modeling of the epidemiological situation of hepatitis C in the North-Western Federal district and Saint Petersburg until 2030

Infekcionnye bolezni ◽

10.20953/1729-9225-2020-3-48-54 ◽

2020 ◽

Vol 18 (3) ◽

pp. 48-54

Author(s):

E.V. E.V.Esaulenko ◽

◽

R.A. R.A.Ganchenko ◽

◽

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Federal District ◽

Hcv Infection ◽

Saint Petersburg ◽

Number Of Patients ◽

North Western ◽

Epidemiological Situation

Currently, there is an urgent need to monitor the epidemiological situation of the infection caused by hepatitis C virus (HCV) and control its early diagnosis. Objective. To determine the public health burden of HCV infection in Saint Petersburg (SPb) and North-Western Federal district (NWFD), to predict the epidemiological situation, and to identify measures that should be taken to achieve the goals mentioned in the WHO strategy by 2030. Materials and methods. We have developed a dynamic model of disease progression for quantitative assessment of HCV burden by stages of liver disease for 1950–2030 in collaboration with the Center for Disease Analysis, USA. Results. With the existing approach to HCV diagnosis and treatment, the number of patients with chronic hepatitis C in SPb and NWFD will continue to grow and reach 332,000 and 193,000 cases respectively. We expect at least a two-fold increase in the number of deaths associated with liver disease and in the number of patients with decompensated cirrhosis and hepatocellular carcinoma in both SPb and NWFD. Changes in the approaches currently used for HCV treatment and implementation of additional measures will help to achieve main WHO goals by 2030. Conclusion. Implementation of the WHO strategy in the NWFD and SPb has obvious advantages, but requires significant resources and optimization of existing approaches to the diagnosis and treatment of HCV infection in the region. Keywords: HCV infection, chronic hepatitis C, WHO strategy to eliminate hepatitis C

Download Full-text

Importance of studying the levels of hepcidin and vitamin D in Egyptian children with chronic hepatitis C

Journal of Translational Internal Medicine ◽

10.2478/jtim-2019-0004 ◽

2019 ◽

Vol 7 (1) ◽

pp. 15-21 ◽

Cited By ~ 3

Author(s):

Amal Ahmed Mohamed ◽

Eman R. Abd Almonaem ◽

Amira I. Mansour ◽

HebatAllah Fadel Algebaly ◽

Rania Abdelmonem Khattab ◽

...

Keyword(s):

Vitamin D ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Iron Metabolism ◽

Hcv Infection ◽

Vitamin D Levels ◽

Egyptian Children ◽

Serum Hepcidin

Abstract Background and Objective Hepcidin is the key regulator of iron metabolism and is a significant biomarker for systemic inflammatory states. Vitamin D is a powerful immunomodulator and plays a significant role in the inflammatory responses and fibrosis occurring due to hepatitis C virus (HCV) infection. This study assessed the level of vitamin D and serum hepcidin and its expression in peripheral blood of children with chronic hepatitis C (CHC) and correlated them with other serum markers to reflect iron metabolism and liver disease severity. Methods A total of 100 children were included in this study: 50 with HCV infection and 50 healthy controls. Biochemical parameters together with vitamin D, hepcidin, and its expression were all measured. Results The level of hepcidin and its expression together with vitamin D and hepcidin-to-ferritin (H/F) ratios were significantly reduced in patients, but the iron and ferritin levels were higher (P<0.001). Serum hepcidin level showed significant positive correlation with hepcidin expression, HCV titer, iron, ferritin, and H/F ratio (r = 0.43, 0.31, 0.34, 0.28, and 0.91, respectively) but significant negative correlation with vitamin D (r = −0.37). Both hepcidin and ferritin were higher in patients with Child Pugh scores B and C than those with score A (P<0.001). Conclusion Measuring serum hepcidin and its expression together with vitamin D levels in patients may have a prognostic value and is promising in the follow-up of the severity of liver disease.

Download Full-text

910 ABNORMAL EEG ACTIVITY IN PATIENTS WITH CHRONIC HEPATITIS C (HCV) INFECTION AND MINIMAL LIVER DISEASE

Journal of Hepatology ◽

10.1016/s0168-8278(12)60922-2 ◽

2012 ◽

Vol 56 ◽

pp. S354

Author(s):

E. Williams ◽

M. Herren ◽

C.D. Jackson ◽

H. Pflugrad ◽

J. Krause ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Eeg Activity

Download Full-text

Efficiency of a combined peginterferon alpha-2a and ribavarin therapy in intravenous opiate substances abusers with chronic hepatitis C

Vojnosanitetski pregled ◽

10.2298/vsp0910791j ◽

2009 ◽

Vol 66 (10) ◽

pp. 791-795 ◽

Cited By ~ 1

Author(s):

Maja Jovanovic ◽

Ljiljana Konstantinovic ◽

Velimir Kostic ◽

Miodrag Vrbic ◽

Lidija Popovic

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Combined Therapy ◽

Hcv Infection ◽

Special Treatment ◽

Hcv Rna ◽

Significant Difference ◽

Patient Groups ◽

Chronic Hcv

Background/Aim. The most important ethiology factor of chronic liver disease that progresses into terminal insufficiency is hepatitis C virus (HCV) infection. Intravenous (iv) drug abuse is the main cause for spreading HCV. Thus the therapy for such patients is of extreme importance in reducing the incidence of the disease. The aim of the study was to establish efficacy of a combined therapy with peginterferon alpha-2a and ribavirin in iv opiate substances abusers having chronic HCV infection in relation to sex, age, genotype and level of fibrosis and duration of HCV infection before the treatment. Methods. Thirty one iv opiate substances abusers with chronic hepatitis C (HHC) were enrolled in the examination. The patients were divided according to the genotype into two groups. The patients with genotypes 1 and 4 (n = 18) were treated for 48 weeks, while those with genotypes 2 and 3 (n = 13) for 24 weeks. PCR HCV RNA, genotype determination and liver biopsy were done to each patient. Results. A stabile virological response was achieved in 93.5% of the patients, so the therapy demonstrated statistically significant efficacy i. v. opiate substances abusers with HHC (p < 0.001). There was no statistically significant difference in therapeutic response among patient groups formed according to the genotype, sex, duration of the disease and level of fibrosis (p > 0.05). Conclusion. Therapy of of iv opiate substances abusers with HHC has its specificities, and these patients need special treatment. Efficacy of the therapy was equivalent in patient groups formed according to the sex, genotype, level of fibrosis and duration of HCV infection. A combined therapy with peginterferon alfa 2a and ribavirin has high level of success in the treatment of these patients.

Download Full-text

Structure of Patients with Hepatocellular Cancer (Data Analysis from Two Specialised Centres)

Russian Journal of Gastroenterology Hepatology Coloproctology ◽

10.22416/1382-4376-2020-30-2-58-67 ◽

2020 ◽

Vol 30 (2) ◽

pp. 58-67

Author(s):

M. V. Mayevskaya ◽

M. S. Novruzbekov ◽

I. M. Borovkov ◽

D. G. Trofimova ◽

M. S. Zharkova ◽

...

Keyword(s):

Liver Transplantation ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Liver Diseases ◽

Hepatocellular Cancer ◽

Number Of Patients ◽

Before And After ◽

Twofold Decrease

Aim. To identify trends in the structure of patients with liver diseases, in particular hepatocellular cancer (HCC), by analysing the experience of two specialised medical centres.Materials and methods. A retrospective analysis of the medical records of hepatological patients who sought medical treatment at to the V.Kh. Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology of the Sechenov University in 2013, 2014 and 2017 (total 2459 patients) was carried out. The number of patients with chronic viral hepatitis (CVH) was 651, with non-alcoholic fatty liver disease (NAFLD) — 590, with alcoholic liver disease (ALD) — 66, with autoimmune liver diseases — 416, with liver cirrhosis (LC) of any etiology 407, other liver diseases — 329. A retrospective analysis of the medical records of patients with HCC who were examined and treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2008 to 2017 (n = 86) was carried out.Results. The ratio of patients with chronic hepatitis C and B in 2013–2017 significantly changed. An almost twofold decrease in the number of patients with chronic hepatitis C (210 patients in 2013 and 141 patients in 2017) and an increase in the number of patients with chronic hepatitis B (20 patients in 2013 and 45 patients in 2017) was observed. An almost twofold increase in the total number of NAFLD patients was detected (163 patients in 2013 and 276 patients in 2017). The number of ALD patients increased from 12 patients in 2013 to 31 patients in 2017. The proportion of patients with autoimmune liver diseases in the overall structure of patients who applied to the department was 20 % in 2013, 13.6 % in 2014 and 10.8 % in 2017. An almost twofold decrease in the number of patients with alcoholic LC and LC associated with HBV was observed (73 patients and 17 patients in 2013 and 38 patients and 6 patients in 2017, respectively) as well as a noticeable increase in the number of patients with alcoholic LC and LC associated with HCV (6 patients and 51 patients in 2013 and 26 patients and 75 patients in 2017, respectively). In the analysis of HCC patients, the ratio of men to women was 3:1 (64 men and 22 women), the median age was 54.5 years (IQR 48–59). The median time from the establishment of chronic liver disease to the detection of HCC was 7.5 years (IQR 3–14.5). In 86 % of cases, the HCC development was preceded by cirrhosis (Child-Pugh A: n = 24; Child-Pugh B: n = 30; Child-Pugh C: n = 20), in 14 % — by chronic hepatitis. Viral liver lesions were the leading cause of HCC in 79 % (n = 68), ALD in 4 % (n = 3), NAFLD in 1 % (n = 1), AIH in 1 % (n = 1). In 10 % (n = 9), a combined liver lesion was observed, in 5 % (n = 4), no previous liver disease was known. The highest five-year survival rate (100 %) was found in the group of patients who received antiviral therapy (AVT) before and after liver transplantation.Conclusions. NAFLD, ALD, and chronic hepatitis B patients began to seek medical help more frequently. An increase in the number of patients with autoimmune LC and LC associated with chronic hepatitis C virus (HCV) infection was observed. The conducted analysis of trends in the structure of HCC patients showed that chronic HCV and HBV infection is the main prerequisite for the development of cancer. Liver transplantation is the most effective treatment for HCC. AVT before and after liver transplantation allows a statistically significant increase in the five-year posttransplant survival of HCC patients with chronic hepatitis C to be achieved.

Download Full-text

Estimated future disease burden of hepatitis C in Chelyabinsk region by 2030: possible scenarios

Infekcionnye bolezni ◽

10.20953/1729-9225-2020-4-85-92 ◽

2020 ◽

Vol 18 (4) ◽

pp. 85-92

Author(s):

O.I. Sagalova ◽

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Disease Burden ◽

Hcv Infection ◽

Diagnosis And Treatment ◽

Access To Treatment ◽

Number Of Patients ◽

Chelyabinsk Region ◽

Epidemiological Situation

There is still an urgent need for accurate monitoring of the epidemiological situation of hepatitis C virus (HCV), its early diagnostics, broad access to treatment, and effective follow-up. Objective. Тo develop a model allowing the estimation of disease burden of hepatitis C in Chelyabinsk region, prognosis of the epidemiological situation, and planning of necessary measures to achieve the strategy goals of WHO by 2030. Materials and methods. We have developed a dynamic model of disease progression for quantitative assessment of HCV burden by liver disease stages in 1950–2030 using Microsoft Excel. This model was similar to that used in previous studies. Results and discussion. Our model demonstrated that total number of patients with chronic hepatitis C in Chelyabinsk region will continue to grow and reach 125,000 patients by 2030, if the approach to the diagnosis and treatment remains unchanged. Approximately 5,300 new cases of chronic hepatitis C will be registered every year. Alterations in the approach to HCV therapy (increased number of patients on treatment, therapy initiation regardless of liver fibrosis stage) along with some additional measures will ensure the achievement of key WHO targets by 2030. Conclusion. The achievement of WHO targets in Chelyabinsk Region by 2030 appears possible, but it requires significant resources and optimization of existing approaches to the diagnosis and treatment of HCV infection in the region. Key words: HCV infection, WHO strategy for hepatitis C elimination, chronic hepatitis C

Download Full-text