MATHEMATICAL MODELLING IN FORECASTING THE EFFICIENCY OF TREATMENT OF CHRONIC HEPATITIS C IN CHILDREN

The study developed a model to predict the response to therapy of children with chronic hepatitis C (CHC) based on a system of multivariate analysis. The mathematical model allows timely correction of treatment, significantly increasing the number of early virologic responses and reducing the probability of recurrence of the disease. Aim -optimization of treatment prior to the onset of therapy with subsequent forecasting of the effectiveness of therapy based on multivariate regression analysis. Materials and methods. The study included 116 patients at the age of 3-18 years with CHC in the replicative phase. Children with CHC were divided into 2 groups of 58 patients. Observations in children with CHC were made using clinical, biochemical, immunological and instrumental methods of research, which helped to obtain the most complete information about children with chronic viral hepatitis C. In the course of the conducted multiple regression analysis, we selected the most significant indicators for the establishment of the resulting mathematical model. Results. The method of forecasting response to therapy in chronic hepatitis C in children, developed on the basis of multivariate regression analysis and mathematical modelling of the most important immunological and biochemical parameters, is clinically efficient and justified.

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Faculty Opinions recommendation of IFNL3 polymorphisms predict response to therapy in chronic hepatitis C genotype 2/3 infection.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718363760.793494617 ◽

2014 ◽

Author(s):

Philip Rosenthal

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Response To Therapy ◽

Genotype 2

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Predicting response to therapy in chronic hepatitis C: An approach combining interleukin-28B gene polymorphisms and clinical data

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.2011.06834.x ◽

2012 ◽

Vol 27 (2) ◽

pp. 279-285 ◽

Cited By ~ 18

Author(s):

José M Ladero ◽

Elena García Martin ◽

Cristina Fernández ◽

Miguel Carballo ◽

María J Devesa ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Clinical Data ◽

Gene Polymorphisms ◽

Response To Therapy ◽

Interleukin 28B

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IL28B polymorphisms, IP-10 and viral load predict virological response to therapy in chronic hepatitis C

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2011.04635.x ◽

2011 ◽

Vol 33 (10) ◽

pp. 1162-1172 ◽

Cited By ~ 66

Author(s):

G. Fattovich ◽

L. Covolo ◽

S. Bibert ◽

G. Askarieh ◽

M. Lagging ◽

...

Keyword(s):

Chronic Hepatitis ◽

Viral Load ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Virological Response ◽

Response To Therapy

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Histopathological and immunocytochemical changes in the liver of patients with chronic hepatitis C

Vojnosanitetski pregled ◽

10.2298/vsp0401029j ◽

2004 ◽

Vol 61 (1) ◽

pp. 29-34

Author(s):

Maja Jovanovic ◽

Ljiljana Konstantinovic ◽

Vuka Katic ◽

Slavisa Ciric ◽

Velimir Kostic ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Liver Damage ◽

Liver Parenchyma ◽

Hepatic Tissue ◽

Biopsy Specimens ◽

Viral Hepatitis C ◽

Viremia Level ◽

Chronic Active Viral Hepatitis

Background. The presence of lymphocytes within the liver parenchyma is related to immunologically mediated liver damage in chronic hepatitis C. The aim of the study was to make histological, histochemical, and immunocytochemical assessment of liver biopsy specimens in patients with chronic hepatitis C virus (HCV) infection. Methods. Biopsy specimens of 20 patients with chronic HCV disease were analyzed, using standard staining procedures to verify histologic liver lesions, as well as immunoenzymatic staining with monoclonal antibodies to detect CD4+ T-lymphocytes, B-lymphocytes, and macrophages. Results. Micromorphologic characteristics of chronic active viral hepatitis C were present in all the patients, differing, hower, by the level of their activity. Dominant changes were found within the portal space, consisting of mononuclear lympho-plasmocytic infiltration and macrophages. Immunocytochemical investigation of mononuclear and macrophageal infiltration showed the correlation between micromorphological findings and the degree of the activity. Conclusion. The presence of lymphocytic and macrophageal infiltration within the hepatic tissue directly correlated with the intensity of the liver damage. Analysis of the population of cellular infiltrate in the liver together with the monitoring of viremia level and the level of hepatocyte necrosis, could be useful tools for elucidation of the pathogenesis of chronic hepatitis C.

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Significance of iron reduction for the therapy of chronic hepatitis C

Vojnosanitetski pregled ◽

10.2298/vsp0502161n ◽

2005 ◽

Vol 62 (2) ◽

pp. 161-164 ◽

Cited By ~ 1

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.

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Prediction of Sustained Virological Response to Peginterferon-based Therapy for Chronic Hepatitis C: Regression Analysis of a Cohort from Rio Grande do Sul, Brazil

Euroasian Journal of Hepato-Gastroenterology ◽

10.5005/jp-journals-10018-1207 ◽

2017 ◽

Vol 7 (1) ◽

pp. 27-33

Author(s):

Rafael V Picon ◽

Lúcia Fendt ◽

Karine Amaral ◽

Paulo D Picon

Keyword(s):

Regression Analysis ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Sustained Virological Response ◽

Chronic Hepatitis C ◽

Virological Response ◽

Negative Likelihood Ratio ◽

Rio Grande ◽

Prediction Tool ◽

Rio Grande Do Sul

ABSTRACT Aim Peginterferon plus ribavirin (peg-IFN/RBV) is still the standard of care for treatment of hepatitis C virus (HCV) in many countries. Given the high toxicity of this regimen, our study aimed to develop a prediction tool that can identify which patients are unlikely to benefit from peg-IFN/RBV and could thus postpone treatment in favor of new-generation direct-acting antivirals. Materials and methods Binary regression was performed using demographic, clinical, and laboratory covariates and sustained virological response (SVR) outcomes from a prospective cohort of individuals referred for therapy from 2003 to 2008 in a public HCV treatment center in Rio Grande do Sul, Brazil. Results Of the 743 participants analyzed, 489 completed 48 weeks of treatment (65.8%). A total of 202 of those who completed peg-IFN/RBV therapy achieved SVR (27.2% responders), 196 did not (26.4%), and 91 had missing viral load (VL) at week 72 (12.2% loss to follow-up). The remainder discontinued therapy (n = 254 [34.2%]), 78 (30.7%) doing so due to adverse effects. Baseline covariates included in the regression model were sex, age, human immunodeficiency virus, infection status, aspartate transaminase, alanine transaminase, hemoglobin, platelets, serum creatinine, prothrombin time, pretreatment VL, cirrhosis on liver biopsy, and treatment naivety. A predicted SVR of 17.9% had 90.0% sensitivity for detecting true nonresponders. The negative likelihood ratio at a predicted SVR of 17.9% was 0.16, and the negative predictive value was 92.6%. Conclusion Easily obtainable variables can identify patients that will likely not benefit from peg-IFN-based therapy. This prediction model might be useful to clinicians. Clinical significance To our knowledge, this is the only prediction tool that can reliably help clinicians to postpone peg-IFN/RBV therapy for HCV genotype 1 patients. How to cite this article Picon RV, Fendt L, Amaral K, Picon PD. Prediction of Sustained Virological Response to Peginterferon-based Therapy for Chronic Hepatitis C: Regression Analysis of a Cohort from Rio Grande do Sul, Brazil. Euroasian J Hepato-Gastroenterol 2017;7(1):27-33.

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Ineffective Absorption? Failure of Direct-Acting Therapy for Chronic Hepatitis C in Cirrhotic Patients With Roux-en-Y Gastric Bypass

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709619858127 ◽

2019 ◽

Vol 7 ◽

pp. 232470961985812

Author(s):

Clara Y. Tow ◽

John F. Reinus

Keyword(s):

Gastric Bypass ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Virologic Response ◽

Response To Therapy ◽

Direct Acting Antiviral ◽

Cirrhotic Patients ◽

Direct Acting ◽

Short Courses

In this era of direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection, treated patients have extremely high rates of sustained virologic response to short courses of therapy regardless of stage of fibrosis. Treatment failure is uncommon and often attributed to medication noncompliance or viral resistance to drug. This report describes 2 Child-Pugh-A cirrhotic patients who failed to clear HCV in response to therapy with DAAs. Each patient had Roux-en-Y gastric bypass (RYGB) surgery preceding DAA therapy. RYGB may create multiple barriers to adequate DAA absorption as a result of changes in gastrointestinal physiology. Treatment monitoring and duration should be carefully considered in this unique patient population.

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