RESUMEN
BACKGROUND: Hepatitis C virus (HCV) genotype 4 is a common infection in Egypt and is the leading cause of liver disease. OBJECTIVE: To study the efficacy and safety of a novel 20 kD pegylated interferon alpha-2a derived from Hansenula polymorpha in combination with ribavirin for the treatment of Egyptian patients with genotype 4 chronic hepatitis C (CHC). METHODS: One hundred seven patients with genotype 4 CHC were involved in the present study. Liver biopsy was performed in all patients. All patients received a fixed weekly dose of 160 µg of a novel pegylated interferon in combination with ribavirin in standard and adjusted doses. Serum HCV RNA levels were assessed by a real-time sensitive polymerase chain reaction assay at four, 12, 48 and 72 weeks after the start of therapy. Patients demonstrating an early virological response (EVR) completed a 48-week course of treatment. RESULTS: The overall sustained virological response (SVR) was 60.7%. The SVR in patients with a rapid virological response was significantly higher (91.7%) than in patients with complete EVR (67.74%) (P=0.033) and partial EVR (56.14%) (P=0.003). SVR was also significantly higher in patients with a low degree of liver fibrosis according to Metavir score (F1 and F2) (67.57%) compared with those with a high degree of liver fibrosis (F3 and F4) (45.45%) (P=0.017). The baseline viral load had no impact on SVR in the present series nor were any serious adverse events reported. CONCLUSION: The novel pegylated interferon alpha-2a assessed in the present study was effective for the treatment of patients with genotype 4 CHC, and was safe and well tolerated.
Asunto(s)
Antivirales/uso terapéutico , Hepacivirus , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Adulto , Quimioterapia Combinada , Egipto , Femenino , Genotipo , Hepacivirus/aislamiento & purificación , Hepatitis C Crónica/virología , Humanos , Interferón alfa-2 , Masculino , Persona de Mediana Edad , Proteínas Recombinantes , Resultado del Tratamiento , Carga Viral , Adulto JovenRESUMEN
Radiofrequency ablation (RFA) is a well known therapeutic modality in the curative treatment of hepatocellular carcinoma (HCC). The aim of this work was to assess the efficacy of percutaneous RFA in patients with tumors < or = 3.5 cm regarding the ability to achieve full tumor necrosis and local recurrence in patients with previous schistosomal infection. A total of 89 patients with HCC < or = 3.5 cm were included in this work (45 with schistosomiasis; group I and 44 without history of schistosomiasis; group II). History of schistosomiasis was documented by positive serum schistosomal antibodies and/or detection of Schistosoma ova in rectal snip examination. HCC was diagnosed by detection of hepatic nodule on ultrasound examination in the background of cirrhotic liver or chronic hepatitis together with elevated serum alphafetoprotein (AFP) (> 400 ng/ml) and/or typical pattern of triphasic CT examination. RFA was employed to all patients. Triphasic CT examination was performed 1 month after the end of procedure and at three months interval for one year of follow up. Ultrasound examination and AFP were performed at 3 months interval for the same follow up period. Recurrence was considered when typical criteria were detected at triphasic CT examination. The results showed that full necrosis of the tumor was achieved in 42 patients in group I (93.3%) and in 41 patients in group II (93.18%); (P > 0.05)). Recurrence after 1 year was detected in 11 patients of group I (26.19%) and 12 patients of group II (29.27%), (P > 0.05).