Comparison of Impairment of PFT due to Plain Vs Pegylated Interferon Therapy in pts With Ch. Hepatitis C Virus Infection

Aim: To compare Impairment of pulmonary function tests due to plain versus pegylated interferon therapy in the diagnosed cases of chronic Hepatitis C Methodology: In this comparative study, 71 patients fulfilling inclusion criteria were randomly included in each group. Study consisted; Group 1 (Control Group): Pulmonary Function Tests performed before and after the completion of 24 weeks of treatment with Plain/conventional Interferons and ribavirin. Group 2 (experimental Group): PFTs performed before and after the completion of 24 weeks treatment with Pegylated Interferon Therapy and ribavirin. Referred patients of both groups underwent spirometry (PFTs) at baseline and at the end of 6 months Results: Mean value observed for age was 49.86, for height 1.592 meters, for weight 62.6 kg and for BMI 24.9. Before and after therapy mean for FEV1 was 90.19 and 67.71 and it was 91.34 and 67.83 for FVC respectively. N=71 patients were enrolled in both groups. Male gender showed high prevalence 70%. Group-1 (46 vs 25) & group-2 (45 vs 26) male to female ratio seen. Adult age group hold bulk of disease (30 - 40 years of age). Patients preferred winter season for treatment (Sep to Nov). Low viral load and genotype 3a were common findings (82% and 35%). Constitutional symptoms improved after therapy (86 to 44%) as a whole. Individually, anorexia, body aches, lethargy and fever were like this (39 vs 19%, 66 vs 28%, 54 vs 30%, 19 vs 11%) pre and post therapy. Cough and dyspnea reported in 7% and 20% respectively. Conclusion: According to the present study, treatment with pegylated interferon and ribavirin is associated with impairment of pulmonary function tests similarly as treatment with plain interferon and ribavirin. Long Half-life of pegylated interferon cause more impairment in lung functions as indicated by limited available literature (Foster GR et al). Keywords: Chronic hepatitis C, Pulmonary function tests, plain/Conventional interferon therapy, Pegylated interferon therapy.

Mixed Cryoglobulinaemia Vasculitis after Persistent Hepatitis C Virus Eradication

Mixed cryoglobulinaemia vasculitis (MCV) is a systemic vasculitis of the small and medium-size vessels caused by active hepatitis C (HCV) infection in >80% of cases. Beuthien et al. presented the first case of MCV with undetectable HCV after 10 months of therapy. In the last few years, more authors have described other cases of symptomatic MCV after 1 year of persistent HCV eradication. Here, we present a case report of a 57-year-old man who developed MCV with renal involvement after 3 years of HCV eradication with interferon therapy.

A model of the innate immune response to SARS-CoV-2 in the alveolar epithelium

We present a differential equation model of the innate immune response to SARS-CoV-2 within the alveolar epithelium. Critical determinants of the viral dynamics and host response, including type I and type II alveolar epithelial cells, interferons, chemokines, toxins and innate immune cells, are included. We estimate model parameters, compute the within-host basic reproductive number, and study the impacts of therapies, prophylactics, and host/pathogen variability on the course of the infection. Model simulations indicate that the innate immune response suppresses the infection and enables the alveolar epithelium to partially recover. While very robust antiviral therapy controls the infection and enables the epithelium to heal, moderate therapy is of limited benefit. Meanwhile interferon therapy is predicted to reduce viral load but exacerbate tissue damage. The deleterious effects of interferon therapy are especially apparent late in the infection. Individual variation in ACE2 expression, epithelial cell interferon production, and SARS-CoV-2 spike protein binding affinity are predicted to significantly impact prognosis.

Topical interferon in recurrent inflammatory macular edema following a cat bite

Introduction: Treating chronic macular edema (CME) post endophthalmitis is a challenge. Use of steroids may reactivate the infection and repeated intravitreal therapy with anti-vascular growth factor inhibitors (Anti-VEGF) puts the patient again at the risk of exacerbation of inflammation or endophthalmitis. We describe a case of CME post traumatic endophthalmitis successfully treated with topical interferon therapy. Case description: A 34-year-old Asian Indian lady with a history of cat bite to her right eye and treated elsewhere as traumatic endophthalmitis with recurrent macular edema, presented to us 1 year after the injury. She had received anti-VEGF injection for same. Her medical history was non-contributory except for close contact with her cat. Therapeutic trials with oral doxycycline followed by oral albendazole with steroids, as well as repeated anti-VEGF therapy failed to prevent recurrence of CME. Patient’s steroid responsiveness and reluctance for injections, made us to opt for a novel topical Interferon therapy. Macular edema resolved in 2 months. Interruption of interferon therapy due to COVID-lock down resulted in recurrence of the CME, which again responded well to interferon monotherapy. Conclusion: Topical interferon may have a role in the treatment of inflammatory macular edema and can serve as a, safer, economical and non-invasive treatment option compared to intravitreal steroids and anti-VEGFs.

Consensus ‘Interferon therapy for patients with influenza, SARS and COVID19’

According to the who, the share of acute respiratory viral infections (амма? and influenza) accounts for about 90–95% of all infectious diseases; in russia, influenza and arvi take up to 40% of the total duration of official disability, which determines the significance of this pathology. At the same time, the primary contact of the overwhelming majority of patients with suspected arvi and influenza occurs with a therapist or general practitioner of polyclinics. The proposed consensus of experts is intended to systematize the known approaches to the diagnosis, treatment and secondary prevention of influenza, acute respiratory viral infections and community-acquired pneumonia for their use at outpatient clinics. The schemes of using interferon therapy for arvi and influenza are considered in detail.