RESUMO
BACKGROUND: In the follow up of chronic hepatitis B infection (HBV), a significant correlation between quantitative HBsAg titer measurement and HBV DNA level, and moreover with intrahepatic covalently closed circular DNA was already shown. However, besides their impact on long-term follow up, they are really expensive methods, and not available widespread. We aimed to investigate the utility of qualitative measurement of HBsAg titer in prediction of virologic response at the end of the first year of anti-viral treatment in chronic HBV infection. MATERIAL AND METHODS: A total of 70 patients receiving anti-viral therapies for chronic HBV infection were included into the study. The patients were evaluated according to Hbe Ag status and response to treatment. The determinations used in the study (biochemical, virologic responses, primary non-response) were accepted as it was described in AASLD. RESULTS: Qualitative HBsAg titer increased significantly in both HBeAg positive and negative patients (p values 0.002 and < 0.000). Increasing of HBsAg titer in first three months is more dramatic in responder group, however the difference was disappeared at the sixth and twelve moths on follow up. Similarly, a fast increasing in anti-HBe titer in HBeAg negative chronic HBV patients was related with higher response at the end of first year therapy. However, the changings at the 12th month of anti-viral treatment were similar in both responder and non-responder groups. CONCLUSION: In conclusion, the fast increase in qualitative measurement of HBsAg titer seemed to be a predictor of higher anti-viral medication success in chronic HBV patients. However, this meaningful increasing was disappeared on the follow up, particularly after the six months examination.
Assuntos
Antivirais/uso terapêutico , DNA Viral/sangue , Farmacorresistência Viral , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite B Crônica/sangue , Hepatite B Crônica/tratamento farmacológico , Adenina/análogos & derivados , Adenina/farmacologia , Adenina/uso terapêutico , Adulto , Idoso , Antivirais/farmacologia , Biomarcadores/sangue , Feminino , Seguimentos , Guanina/análogos & derivados , Guanina/farmacologia , Guanina/uso terapêutico , Vírus da Hepatite B/efeitos dos fármacos , Hepatite B Crônica/imunologia , Humanos , Interferons/farmacologia , Interferons/uso terapêutico , Lamivudina/farmacologia , Lamivudina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Organofosfonatos/farmacologia , Organofosfonatos/uso terapêutico , Valor Preditivo dos Testes , Tenofovir , Fatores de Tempo , Resultado do TratamentoRESUMO
The results of the acute exacerbations of hepatitis B virus are varied from silent to severe acute hepatitis. HBsAg seroconversion induced by either antiviral drugs or occurred spontaneously, as a targeted end point of HBV infection management is infrequent. The affect of the severe hepatitic flare on HBsAg seroconversion was reported before, however the predictive markers of HBsAg seroconversion are not clear yet. The reasons of the spontaneously HBV re-activations, or its usual results are not known well. We, herein reported a case, with the high serum HBV DNA titer during an acute spontaneously induced severe exacerbation of HBV infection which spontaneously resulted in total HBV recovery.
Assuntos
Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B Crônica/diagnóstico , Ativação Viral , Adulto , DNA Viral/sangue , Vírus da Hepatite B/genética , Humanos , Masculino , Índice de Gravidade de Doença , Carga ViralRESUMO
Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by actinomyces israeli. Intravenous penicillin is the preferred antimicrobial but it requires hospitalization up to one month. An outpatient treatment strategy would be cost effective and a good choice for patients. Here we present three cases in which intramuscular ceftriaxone was successfully used in the outpatient settings following surgery and IV penicillin treatment in the hospital.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Actinomicose/tratamento farmacológico , Antibacterianos/administração & dosagem , Ceftriaxona/administração & dosagem , Infecção Pélvica/tratamento farmacológico , Penicilinas/administração & dosagem , Assistência Ambulatorial , Injeções Intramusculares , Infecção Pélvica/microbiologia , Resultado do TratamentoRESUMO
Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by actinomyces israeli. Intravenous penicillin is the preferred antimicrobial but it requires hospitalization up to one month. An outpatient treatment strategy would be cost effective and a good choice for patients. Here we present three cases in which intramuscular ceftriaxone was successfully used in the outpatient settings following surgery and IV penicillin treatment in the hospital.