ABSTRACT
To investigate the antiviral efficacy of combination therapy with pegylated-interferon alpha (peg-IFNa)-2a and ribavirin (RBV) in hepatitis C patients with liver cirrhosis after splenectomy or partial splenic embolization. Forty-nine hepatitis C patients with liver cirrhosis who were unable to use antiviral therapy because of hypersplenism were recruited for study and treated with splenectomy or partial splenic embolization. Three months later, a regimen of antiviral combination therapy was initiated with peg-IFNa-2a (once-weekly subcutaneous injection: 135 μg or 180 μg) and RBV (daily oral: 800 to 1200 mg), and was maintained for 48 weeks. The patients were followed up at treatment weeks 1, 2, 4, 6, 8, and 12. Thereafter, follow-up was conducted every four weeks. The patients were observed until 24 weeks after treatment discontinuation. Follow-up testing included liver function, blood chemistry, renal function, and HCV RNA level. Any adverse reactions were recorded. Liver cirrhosis patients complicated by hypersplenism can be treated effectively with peg-IFNa-2a/RBV combination antiviral therapy after splenectomy or partial splenic embolization. The antiviral-induced sustained viral response rates was 65.00% in cirrhotic/hypersplenic hepatitis C patients receiving splenectomy and 58.62% in those receiving partial splenic embolization. Hypersplenism patients with hepatitis C-related cirrhosis achieved a good antiviral therapeutic effect with peg-IFNa-2a/RBV combination therapy following splenectomy or partial splenic embolization. This sequence of treatment may help to decrease incidences of chronic hepatitis C-induced liver failure and liver cancer in these patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antiviral Agents , Therapeutic Uses , Combined Modality Therapy , Hepatitis C , Therapeutics , Interferon-alpha , Therapeutic Uses , Liver Cirrhosis , Therapeutics , Polyethylene Glycols , Therapeutic Uses , Postoperative Period , Recombinant Proteins , Therapeutic Uses , Ribavirin , Therapeutic Uses , Splenectomy , Treatment OutcomeABSTRACT
Objective To investigate the features of HIV-1-specific Cytotoxic T-Lymphocyte (CTL)responses in Chinese.Methods The HIV-1-specific CTL responses were analyzed in an IFN-?ELISPOT assay by using a matrix system containing 820 overlapping peptides spanning the entire HIV-1 Clade B and C consensus sequence.Results The HIV-1-specific CTL response almost clus- tered in Gag and Nef across either HIV-1 Clade B(HIV-1 B)or HIV-1 Clade C(HIV-1 C),while oth- er proteins could also be recognized at different level.In comparison of the response between HIV-1 Clade B and Clade C,the magnitude and frequency was roughly identical with some difference found at single-peptide level.The most frequently recognized peptides of HIV-1 B were located in Nef,GPKEP- FRDYVDRFYKTLR(5/17,29.4%)and Gag,LWVYHTQGYFPDWQNY(5/17,29.4%),while the most frequently recognized peptide of HIV-1 C was located in Gag GPKEPFRDYVDRFFKTLR(6/17, 35.29%).Conclusions HIV-1-specific CTL responses clustered within HIV-1 Gag and Nef in Chinese. However,there was some difference between HIV-1 B and HIV-1 C at single-peptide level.