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

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.

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Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

Canadian Journal of Gastroenterology ◽

10.1155/2009/370651 ◽

2009 ◽

Vol 23 (6) ◽

pp. 425-430 ◽

Cited By ~ 9

Author(s):

Jennifer A Flemming ◽

David J Hurlbut ◽

Ben Mussari ◽

Lawrence C Hookey

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Biopsy ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Significant Difference ◽

The Us ◽

Chronic Hcv Infection ◽

Liver Biopsies ◽

Chronic Hcv

BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV)-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US)-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.METHODS: Liver biopsies from 100 patients with chronic HCV infection (50 consecutive US-guided and 50 consecutive non-US-guided), were retrospectively identified using a hospital histopathology database. All original biopsy slides were coded and prospectively reanalyzed by a single hepatopathologist who was blinded to the technique used in obtaining the biopsy. Additionally, all liver biopsies for chronic HCV infection completed at the centre from 1998 to 2007 were identified and the technique used was recorded. Biopsy quality was determined primarily by the number of complete portal tracts (CPTs) identifiable in the slides. The total length of specimen and the degree of fragmentation were secondary outcome measures.RESULTS: There was a slight difference observed between the US-guided and non-US-guided groups in mean age (46.3 years versus 42.5 years, repectively; P=0.018) but no differences in sex, presence of cirrhosis, bilirubin, creatinine, international normalized ratio, and grade or stage of disease. Biopsies obtained using the US-guided technique produced higher quality specimens than the non-US-guided technique based on our primary outcome of number of CPTs in the biopsy (11.8 versus 7.4; P<0.001). US-guided specimens also were longer (24.4 mm versus 19.7 mm; P=0.001), had less fragmentation (P=0.016), and a higher overall histopathological quality assessment (P=0.026) than the non-US-guided biopsies. However, there was no significant difference between the two groups in the ability to grade and stage the disease (96% US-guided versus 90% in non-US-guided (P=0.20). Over a 10-year period, 763 biopsies for chronic HCV infection were identified with an obvious trend toward the increased use of US-guided technique observed at 2% in 1998 to 85% in 2007.CONCLUSIONS: US-guided liver biopsies for chronic HCV are the most common method of obtaining specimens at the Kingston General Hospital, Kingston, Ontario, and are of higher quality than non-US-guided specimens. However, there is no significant difference in the two techniques in the ability to grade and stage chronic HCV.

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Interferon treatment for chronic hepatitis C infection in hemophiliacs-- influence of virus load, genotype, and liver pathology on response

Blood ◽

10.1182/blood.v87.5.1704.bloodjournal8751704 ◽

1996 ◽

Vol 87 (5) ◽

pp. 1704-1709 ◽

Cited By ~ 1

Author(s):

JP Hanley ◽

LM Jarvis ◽

J Andrew ◽

R Dennis ◽

PC Hayes ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Early Stage ◽

Hcv Infection ◽

Hcv Rna ◽

Interferon Treatment ◽

Hepatitis C Infection ◽

Virus Load ◽

Chronic Hcv

In this study, we assessed the effectiveness of interferon treatment in 31 hemophiliacs with chronic hepatitis C virus (HCV) infection. Interferon alfa-2a (3 MU three times weekly) was administered for 6 months. Response was assessed by both serial alanine transaminase (ALT) and HCV RNA levels measured by a sensitive semiquantitative polymerase chain reaction (PCR) method. HCV genotype was determined by restriction fragment length polymorphism (RFLP), and evidence of changing genotypes during interferon therapy was sought. Severity of liver disease was assessed by both noninvasive and invasive methods, including laparoscopic liver inspection and biopsy. Sustained normalization of ALT levels occurred in eight patients (28%), and seven (24%) became nonviremic as assessed by PCR (<80 HCV/mL). Responders universally cleared HCV RNA within 2 months of starting interferon. Genotype 3a was associated with a favorable response to interferon. No evidence was found for a change in circulating genotype in patients who failed to respond to interferon or who relapsed. This study confirms that response rates to interferon are low in hemophiliacs as compared with other groups with chronic HCV infection. We have also demonstrated that virus load measurement over the first 8 to 12 weeks of treatment is an extremely useful method to identify responders at an early stage.

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SNP rs8099917 in GeneIL28BMight Be Associated with Risk of Chronic Infection by HCV but Not with Response to Treatment

BioMed Research International ◽

10.1155/2014/748606 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Simone Regina Souza da Silva Conde ◽

Julius Caesar Mendes Soares Monteiro ◽

Bruna Tereza Silva dos Santos ◽

Nathália Karla Fonseca Filgueiras ◽

Pedro Alves de Almeida Lins ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Pegylated Interferon ◽

Virologic Response ◽

Hcv Infection ◽

Response To Treatment ◽

Genetic Profile ◽

Significant Difference ◽

Chronic Hcv

Aim. The aim of this study was to characterize the genetic profile of patients with chronic hepatitis C virus (HCV) infection relative to polymorphisms rs12979860 and rs8099917 in geneIL28Band the association of those polymorphisms with the response to treatment with pegylated interferon and ribavirin, performed at a reference center in Brazilian Amazonia.Methods. A total of 75 individuals with chronic hepatitis C and 98 healthy individuals from both genders over 18 years old were assessed. DNA samples were collected from leukocytes and subjected to real-time polymerase chain reaction to genotype polymorphisms rs12979860 and rs8099917.Results. Analysis of the allelic and genotypic frequencies of the investigated polymorphisms showed that both groups were in Hardy-Weinberg equilibrium; polymorphism rs12979860 exhibited no significant difference between the groups. For polymorphism rs8099917, allele T was significantly less frequent (P=0.0195) among the patients (63.3%) than the controls (75.5%), and the patients were 1.7 times as likely to exhibit allele G. No difference in response to treatment was associated with SNP patterns.Conclusion. The results suggest a possible association of SNP rs8099917 with higher odds of chronic HCV infection but do not indicate a putative influence of the investigated SNPs on the sustained virologic response.

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Interferon treatment for chronic hepatitis C infection in hemophiliacs-- influence of virus load, genotype, and liver pathology on response

Blood ◽

10.1182/blood.v87.5.1704.1704 ◽

1996 ◽

Vol 87 (5) ◽

pp. 1704-1709 ◽

Cited By ~ 28

Author(s):

JP Hanley ◽

LM Jarvis ◽

J Andrew ◽

R Dennis ◽

PC Hayes ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Early Stage ◽

Hcv Infection ◽

Hcv Rna ◽

Interferon Treatment ◽

Hepatitis C Infection ◽

Virus Load ◽

Chronic Hcv

Abstract In this study, we assessed the effectiveness of interferon treatment in 31 hemophiliacs with chronic hepatitis C virus (HCV) infection. Interferon alfa-2a (3 MU three times weekly) was administered for 6 months. Response was assessed by both serial alanine transaminase (ALT) and HCV RNA levels measured by a sensitive semiquantitative polymerase chain reaction (PCR) method. HCV genotype was determined by restriction fragment length polymorphism (RFLP), and evidence of changing genotypes during interferon therapy was sought. Severity of liver disease was assessed by both noninvasive and invasive methods, including laparoscopic liver inspection and biopsy. Sustained normalization of ALT levels occurred in eight patients (28%), and seven (24%) became nonviremic as assessed by PCR (<80 HCV/mL). Responders universally cleared HCV RNA within 2 months of starting interferon. Genotype 3a was associated with a favorable response to interferon. No evidence was found for a change in circulating genotype in patients who failed to respond to interferon or who relapsed. This study confirms that response rates to interferon are low in hemophiliacs as compared with other groups with chronic HCV infection. We have also demonstrated that virus load measurement over the first 8 to 12 weeks of treatment is an extremely useful method to identify responders at an early stage.

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Decreased Frequency of the HLA-DRB1*11 Allele in Patients with Chronic Hepatitis C Virus Infection

Journal of Virology ◽

10.1128/jvi.76.4.1787-1789.2002 ◽

2002 ◽

Vol 76 (4) ◽

pp. 1787-1789 ◽

Cited By ~ 43

Author(s):

Ayla Yenigün ◽

Belma Durupinar

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Class Ii ◽

Hla Class Ii ◽

Hcv Infection ◽

Hcv Rna ◽

Reduced Frequency ◽

Chronic Hcv Infection ◽

Chronic Hcv

ABSTRACT A genetically determined resistance or susceptibility to chronic hepatitis C virus (HCV) infection may make an important contribution to the course of liver disease and may be linked to the human major histocompatibility complex (MHC). The aim of this study was to investigate the HLA class II genotype profile in chronic hepatitis C and to determine the HLA-hepatitis C association. The experimental population was composed of 49 unrelated chronic HCV patients (31 females, 18 males; mean age, 54.4 ± 1.7 years; range, 34 to 73 years). The control population consisted of 43 ethnically matched healthy donors. HLA-DR and -DQ alleles were studied for patients and controls by a PCR-sequence-specific-primer low-resolution method. Anti-HCV was investigated with enzyme-linked immunosorbent assay II, and HCV RNA was investigated with reverse transcriptase nested PCR. The HLA class II allele, DRB1*11, was found at reduced frequency in 49 patients with chronic hepatitis C (anti-HCV and HCV RNA positive) compared to that for controls (22.4 versus 51.0%; P < 0.01, odds ratio = 0.3, confidence interval = 0.1 to 0.7). No further HLA associations with chronic HCV infection were observed, and there was no correlation between the stage of disease and HLA. DRB1*11 was also found at reduced frequency in all HCV antibody-positive patients compared to controls (corrected P = not significant). DRB1*11 was associated with chronic HCV infection, and it is possible that HLA-DRB1*11 may have a protective feature in chronic HCV infection. In addition, DRB1*11 was associated with protection from HCV infection. These findings suggest that host HLA class II genotype is an important factor determining the outcome of infection with HCV.

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Relationship between Duffy Antigen Receptor for Chemokines and Clinical Characteristics in Han People with Chronic Hepatitis C Infection in Dalian, China

10.32592/ircmj.2020.22.10.146 ◽

2020 ◽

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Hepatic Fibrosis ◽

Protective Factor ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Duffy Antigen ◽

Chronic Hcv

Background and Objectives: Most patients with untreated chronic hepatitis C virus (HCV) infection develop hepatic fibrosis. Hepatic disease progression is monitored with hematological markers (alanine aminotransferase [ALT], aspartate aminotransferase [AST], albumin and platelet [PLT] count, AST/ALT ratio, AST/PLT ratio index [APRI], and fibrosis 4 score [FIB-4]) and FibroScan. The present study aimed to investigate the association between Duffy antigen/chemokines receptor (DARC) polymorphisms and clinical parameters in the Han people with chronic hepatitis C infection in Dalian, China. Materials and Methods: This cohort study was performed on 245 Han people with chronic HCV at Dalian infectious hospital during April-December 2015. The participants of the research were selected using the consecutive sampling method. The DARC genotyping was performed using the TaqMan probe method and transient elastography was measured by FibroScan. Results: Based on the findings, DARC polymorphisms correlated with ALT concentrations (FY*A/FY*A vs. FY*A/FY*B, P=0.025). However, the DARC polymorphism did not have an association with HCV RNA titers (FY*A/FY*A vs. FY*A/FY*B, P=0.241) or hepatic fibrosis (FY*A/FY*A vs. FY*A/FY*B, P=0.325). Moreover, correlation analyses showed that APRI (P<0.001, rho=0.603) and FIB-4 (P<0.001, rho=0.698) were useful predictors of hepatic fibrosis in chronic HCV infection. Besides, HCV RNA titers (P=0.327) and hepatic injury markers (P=0.814, 0.198, 0.767, and 0.171 for ALT, AST, ALB, and AST/ALT, respectively) were not useful for the estimation of the fibrosis stage in patients with chronic hepatitis C. Conclusion: The FY*A allele is a potentially valuable protective factor against hepatocyte damage in chronic HCV-infected patients.

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

Orvosi Hetilap ◽

10.1556/oh.2011.29113 ◽

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.

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

Medicina ◽

10.3390/medicina57060597 ◽

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.

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DIABETES MELLITUS;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.02.629 ◽

2013 ◽

Vol 20 (02) ◽

pp. 220-226

Author(s):

GHAZANFAR ALI SINDHU, ◽

SADAF NAZ, ◽

FRAZ SAEED QURESHI, ◽

Zaheer Ahmed, ◽

Tamur Islam,

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Hcv Rna ◽

Newly Diagnosed

Introduction: Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma(HCC). HCV infection and type 2 diabetes are two common disorders with a high impact on health worldwide. There is growing evidenceto support the concept that HCV infection is a risk factor for developing type 2 Diabetes Mellitus. Both insulin resistance and diabetes canadversely affect the course of chronic hepatitis C, and lead to poor response to antiviral therapy and increased incidence of Hepatocellularcarcinoma. Objective: The objective of the study was to assess the frequency of type 2 Diabetes mellitus in newly diagnosed chronichepatitis C patients presenting in Allied hospital Medical unit II during six month period. Design: Cross sectional study. Setting: Medicalunit-II, Allied Hospital, Faisalabad. Period: 01-08-2009 to 28-02-2010. Material and methods: All newly diagnosed patients of chronichepatitis C on the basis of PCR for HCV-RNA were included in the study. Fasting and two hours postprandial blood sample were tested.Diabetes Mellitus was labeled as per slandered. Results: Out of 180 patients with CHC 19 (10.6%) were found to have Diabetes mellituswhile 161(89.4%) were non-diabetics. Conclusions: There is close association in the development of type 2 diabetes mellitus in patientswith chronic hepatitis C.

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Hepatitis C elimination in the Netherlands (CELINE): study protocol for nationwide retrieval of lost to follow-up patients with chronic hepatitis C

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000396 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000396 ◽

Cited By ~ 2

Author(s):

Cas J Isfordink ◽

Sylvia M Brakenhoff ◽

Marleen van Dijk ◽

Marc van der Valk ◽

Rob J de Knegt ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

The Netherlands ◽

Chronic Hepatitis C ◽

Hcv Rna ◽

Ethical Approval ◽

Hcv Transmission ◽

Chronic Hcv ◽

Lost To Follow Up

BackgroundThe Netherlands has a low hepatitis C virus (HCV) prevalence, estimated at 0.16%. Previous studies have shown that up to 30% of the diagnosed HCV population in the Netherlands has been lost to follow-up (LTFU). Retrieval of these patients could halt progression of liver disease in infected patients, reduce the number of infected individuals and limit HCV transmission. Several regional Dutch retrieval projects have already been executed, which demonstrated that retrieval is feasible. Therefore, we initiated a nationwide retrieval project, aiming to achieve microelimination in previously diagnosed but LTFU patients with chronic HCV through retrieval.MethodsLaboratory records will be used to identify possible patients with chronic hepatitis C, defined as either a positive most recent HCV RNA or positive HCV antibodies without known RNA result. Reviewing patient records and obtaining current contact information from municipality databases will identify LTFU patients who are eligible for retrieval. These patients will be invited for outpatient clinic care. The primary outcome of the study is the total number of LTFU patients who have been successfully linked to care.DiscussionHepatitis C ELimination In the NEtherlands (CELINE) is within the remit of WHO elimination targets and the Dutch National Hepatitis Plan. The methodology of CELINE is based on previously conducted regional retrieval projects and is designed to overcome some of their limitations. After ethical approval was obtained in 2018, the first centre initiated retrieval in 2018 and the project is expected to finish in 2021.Trial registration numberNCT04208035.

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