scholarly journals Fatigue in chronic hepatitis C infection a mixed method study

Author(s):  
Dora Marta Zalai

Fatigue is a main patient reported outcome of chronic hepatitis C (HCV) infection; yet its contributors are unknown. Objectives: The study (1) evaluated fatigue predictors, (2) tested the mediating role of fatigue cognitions, (3) screened for sleep disorders, and (4) explored fatigue from patients’ perspectives. Participants: Both sexes (age>18 years, N = 115) with chronic HCV infection. Design: Cross-sectional. Results: Sixty percent reported severe fatigue (FSS≥4). Fatigue perceptions were the main predictors of fatigue (ß=.58, bias corrected CI = .070-.163). Fatigue perceptions mediated the relationship between comorbidities and fatigue. Half of the sample reported clinically significant symptoms of insomnia and/or sleep apnea. Eight main fatigue themes were endorsed by the participants. Conclusions: Fatigue and sleep disorders were clinically significant issues. Fatigue cognitions may contribute to severe fatigue outcomes. Significance: Integrating the findings into existing sleep and fatigue treatments could improve clinical outcomes.

2021 ◽  
Author(s):  
Dora Marta Zalai

Fatigue is a main patient reported outcome of chronic hepatitis C (HCV) infection; yet its contributors are unknown. Objectives: The study (1) evaluated fatigue predictors, (2) tested the mediating role of fatigue cognitions, (3) screened for sleep disorders, and (4) explored fatigue from patients’ perspectives. Participants: Both sexes (age>18 years, N = 115) with chronic HCV infection. Design: Cross-sectional. Results: Sixty percent reported severe fatigue (FSS≥4). Fatigue perceptions were the main predictors of fatigue (ß=.58, bias corrected CI = .070-.163). Fatigue perceptions mediated the relationship between comorbidities and fatigue. Half of the sample reported clinically significant symptoms of insomnia and/or sleep apnea. Eight main fatigue themes were endorsed by the participants. Conclusions: Fatigue and sleep disorders were clinically significant issues. Fatigue cognitions may contribute to severe fatigue outcomes. Significance: Integrating the findings into existing sleep and fatigue treatments could improve clinical outcomes.


2021 ◽  
Vol 1 (1) ◽  
pp. 35-40
Author(s):  
Syifa Mustika ◽  
Camelia Dwi Jayanti ◽  
Bogi Pratomo Wibowo

Hemodialysis patient are at particular high risk for blood-borne infections. It has been estimated that among patient on hemodialysis, the prevalence of HCV infection is much higher than in general population. Research Objective: To know the prevalence and factors related with Hepatitis C infection in Chronic Kidney Failure patients who underwent chronic hemodialysis in RSUD Dr. Saiful Anwar Malang. Methods: This is a descriptive cross-sectional study. Data was obtained from medical record of hemodialysis patient at Hemodialysis Unit RSUD Dr. Saiful Anwar Malang period April 1, 2016 - March 31, 2017. Results: 688 patients underwent hemodialysis were included in this study, 71 patients (10.323%) positive HCV infection, male 33 patient (46.47%) and female 38 patient (53.53%). The highest positive anti HCV at the age of 48-56 year (24 patient). Patient with blood transfusion were positive 69 patient (97.20%) (p<0.05). Patient on Hemodialysis 5-10 years with positive HCV (60.56%) (p<0.05). From frequency HD one times a week 39 patient and two times a week 32 patient (p<0.05). Based on access type; manual access 48 patient (67.61%), AV shunt 15 patient (21.13%), double lumen 8 patient (11.26%) (p>0.05). Conclusions: Prevalence of chronic hepatitis C infection in CKD on HD is 10.3 %. There is correlation between blood transfusions, duration and frequency of hemodialysis on anti HCV positive. No relationship between access type of hemodialysis with anti HCV positive.


2017 ◽  
Vol 21 (3) ◽  
pp. 565-578 ◽  
Author(s):  
Pegah Golabi ◽  
Mehmet Sayiner ◽  
Haley Bush ◽  
Lynn H. Gerber ◽  
Zobair M. Younossi

Blood ◽  
1996 ◽  
Vol 87 (5) ◽  
pp. 1704-1709 ◽  
Author(s):  
JP Hanley ◽  
LM Jarvis ◽  
J Andrew ◽  
R Dennis ◽  
PC Hayes ◽  
...  

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.


2017 ◽  
Vol 152 (5) ◽  
pp. S1096
Author(s):  
Layth Al-Jashaami ◽  
Hussein Abidali ◽  
Amitkumar Patel ◽  
Myunghan Choi ◽  
Mark Pedersen ◽  
...  

1996 ◽  
Vol 24 (1) ◽  
pp. 132-137 ◽  
Author(s):  
H Simsek ◽  
G Tatar ◽  
C Savas ◽  
H Telatar

Recombinant interferon (IFN) α has been shown to normalize the aminotransferase levels in approximately half of patients with chronic hepatitis C virus (HCV) infection. Twenty four patients with chronic HCV infection were treated with IFN α-2a subcutaneously, three times a week for 6 months. All patients responded to IFN therapy with a decrease of alanine aminotransferase (ALT) level. Thirteen out of 24 cases (54.2%) had normal ALT levels at the end of the sixth month of therapy. However, four of these complete responders (30.8%) relapsed during the 12 month follow-up. Relapse was high in the partial responder group (45.5%). Overall relapse rate was 37.5% at 6 months. HCV genotype II, which is associated with a low response rate to IFN was prevalent (85 – 87%) in our patient population. This study shows that interferon therapy can be effective in reducing transaminase levels in patients with chronic hepatitis C in a population with a high prevalence of HCV type II. The relapse rate after discontinuation of treatment, however, remains a problem.


Author(s):  
Janet Lin ◽  
Cammeo Mauntel-Medici ◽  
Anjana Bairavi Maheswaran ◽  
Sara Baghikar ◽  
Oksana Pugach ◽  
...  

Abstract Background Chronic hepatitis C (HCV) infection affects over 2.4 million Americans and accounts for 18 000 deaths per year. Treatment initiation in this population continues to be low even after introduction of highly effective and shorter duration direct-acting antivirals. This study assesses factors that influence key milestones in the HCV care continuum. Methods Retrospective time-to-event analyses were performed to assess factors influencing liver fibrosis staging and treatment initiation among individuals confirmed with chronic HCV infection at University of Illinois Hospital and Health Sciences System between 1 August 2015 and 24 October 2016 and followed through 28 January 2018. Cox regression models were utilized for multivariable analyses. Results Individuals tested at the liver clinic (hazard ratio [HR] = 2.03; 95% confidence interval [CI]: 1.19–3.46) and at the federally qualified health center (HR = 3.51; 95% CI: 2.19–5.64) had higher instantaneous probability of being staged compared with individuals tested at the emergency department (ED) or inpatient setting. And probability of treatment initiation increased with advancing liver fibrosis especially for Medicaid beneficiaries (HR = 1.64; 95% CI: 1.35–1.99). Conclusions The study demonstrates a need for improving access for patients with early stages of the disease in order to reduce HCV-related morbidity and mortality, especially those tested at nontraditional care locations such as the ED or the inpatient setting.


Blood ◽  
1996 ◽  
Vol 87 (5) ◽  
pp. 1704-1709 ◽  
Author(s):  
JP Hanley ◽  
LM Jarvis ◽  
J Andrew ◽  
R Dennis ◽  
PC Hayes ◽  
...  

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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