Audit of state-funded antiviral treatment for chronic hepatitis C in Qatar

Hepatitis C virus [HCV] infection is a major public health problem in the Middle East. A database of 400 patients with chronic HCV in Qatar was retrospectively analysed: 242 patients underwent antiviral treatment, of whom 212 [87.6%] were naive to treatment. The response to treatment and the predictors of response were studied. The largest group of patients were of Egyptian origin. The rate of sustained virological response [SVR] varied significantly between patients with HCV genotypes 2 or 3 [79.6%] and genotype 1 [45.6%] and 4 [the predominant genotype] [51.0%]. Multivariate analysis showed that the independent predictors of SVR were age < 45 years, infection with genotypes 2 or 3, low fibrosis score on liver biopsy and naive treatment status

Histopathological changes in the gastric mucosa with long-term use of a percutaneous gastrostomy tube [PEG]

Of 95 randomly selected patients using a percutaneous gastrostomy tube [PEG], 20 required tube replacement at least six months after the initial placement. In order to study the possible histopathological changes that might develop in the gastric mucosa with the prolonged use of PEG, gastric biopsies were taken during the replacement procedure. The overall procedure-related minor complication rate was 16.84%; the predominant complication was superficial peristomal wound infection. Other minor complications were tubal migration into the small bowel, surgical emphysema and stomal leak. Histopathological changes seen in six patients showed mild chronic nonspecific gastritis, the predominant cells being lymphocytes and plasma cells. There was no dysplasia or metaplasia. PEG is a safe method of feeding that does not predispose to significant gastric mucosal changes with long-term use. It has a low rate of morbidity even with markedly debilitated patients