ABSTRACT
Covid-19, an infectious disease caused by coronavirus spreads by salivary droplets or nasal discharge from an infected person during sneezing or coughing. This infectious disease is caused by a novel coronavirus, SARS CoV-2 shares the same structure with that of the virus that causes severe acute respiratory syndrome (SARS). Most of the people who are infected with Covid-19 will experience respiratory illness and can be treated with antiviral drugs and or a combination of antiviral drugs and supportive therapies. Many medical investigational approaches are being investigated to design possible treatment strategies and possible avenues for Covid-19 therapy. Potential strategies for the treatment of Covid-19 include antiviral medication, the combination of interferons and antiviral drugs, interleukin inhibitors. Recent studies show that the use of plasma from survivors can help patients in recovering from the disease. This approach of using plasma is termed as convalescent plasma therapy. Another newer technology that includes the construction of a recombinant vaccine is gaining importance for further investigation. The other major approaches include the therapeutic use of serine protease inhibitors, chloroquine, hydroxychloroquine, ammonium chloride in definite doses. New study approaches include investigation on the production of monoclonal antibodies has gained a way for further clinical research. An effective supportive therapy includes extracorporeal membrane oxygenation could be considered as rescued therapy for the patients having respiratory distress. After sufficient clinical data is obtained and by taking all these approaches into consideration, the treatment protocol can be designed to treat Covid-19 successfully.
ABSTRACT
More than 10 million people are suffering from hepatitis C virus (HCV) in Pakistan. The available treatment option is a combination of interferon and ribavirin. Treatment response is linked with several factors and also induces a number of side effects. We searched in Pubmed, Pak Medi Net and Google Scholar for the articles presenting the effect of interferon plus ribavirin therapy on HCV patients from Pakistan, their side effects and future prospects. The major prevalent HCV genotype in Pakistan is 3. Conventional interferon alpha plus ribavirin showed sustained virological response of 54%-64% while pegylated interferon alpha plus ribavirin showed sustained virological response of 58%-75%. IL-28B CC genotype is linked with better sustained virological response. Studies on patients with HCV genotype 3 infections showed no correlation between treatment response and interferon sensitivity determining region mutations. Interferon therapy is linked with a number of side effects like thyroid dysfuncton, haematological disorders, weight loss, gastrointestinal tract side effects and neuropsychiatric side effects. Unusual side effects of clubbing of fingers and seizures were also observed in a couple of patients. Interferon alpha plus ribavirin therapy showed better response rate in HCV genotype 3 patients from Pakistan with number of side effects. A couple of interferon free therapies are light of hope for the patients living with HCV.
ABSTRACT
More than 10 million people are suffering from hepatitis C virus (HCV) in Pakistan. The available treatment option is a combination of interferon and ribavirin. Treatment response is linked with several factors and also induces a number of side effects. We searched in Pubmed, Pak Medi Net and Google Scholar for the articles presenting the effect of interferon plus ribavirin therapy on HCV patients from Pakistan, their side effects and future prospects. The major prevalent HCV genotype in Pakistan is 3. Conventional interferon alpha plus ribavirin showed sustained virological response of 54%-64% while pegylated interferon alpha plus ribavirin showed sustained virological response of 58%-75%. IL-28B CC genotype is linked with better sustained virological response. Studies on patients with HCV genotype 3 infections showed no correlation between treatment response and interferon sensitivity determining region mutations. Interferon therapy is linked with a number of side effects like thyroid dysfuncton, haematological disorders, weight loss, gastrointestinal tract side effects and neuropsychiatric side effects. Unusual side effects of clubbing of fingers and seizures were also observed in a couple of patients. Interferon alpha plus ribavirin therapy showed better response rate in HCV genotype 3 patients from Pakistan with number of side effects. A couple of interferon free therapies are light of hope for the patients living with HCV.
ABSTRACT
Objective] To investigate the relationship between hepatitis B virus( HBV) genotype and their mutations on the development of hepatocellular carcinoma ( HCC ) . [ Methods ] A cohort study on patients with chronic HBV infection was followed up.HBV genotypes were identified by nested multiplex PCR and multiplex PCR.And HBV mutations in the basic core promoter region were sequencing by PCR amplification. [ Results] The patients infected with genotype B were followed up for an average of 8.52 years (IQR:6.67-10.75), of whom the incidence of HCC was 6.55/1 000 person-years.After follow up with an average of 8.87 years (IQR:6.85-11.33), the incidence of HCC was 11.63/1 000 person-years for the patients infected with genotype C, which were significantly higher than those infected with genotype B (P=0.006).In genotype B HBV infected patients, age (≥60 years), cirrhosis can in-crease the risk of HCC, and in genotype C patients, male, age (≥40 years), cirrhosis, C1653T, T1753V, A1762T/G1764A mutation as well.Interferon therapy can reduce the risk of HCC.In genotype C group, interferon treatment reduced HCC risk in patients carrying A1762T/G1764A mutation (HR=0.21, P=0.008) and in those without T1753V ( HR=0.08, P=0.012) and C1653T mutation ( HR=0.17, P=0.013). [Conclusion] HBV genotypes and mutation are closely associated with HCC.Patients infected with genotype C, carrying 1762T/G1764A mutation should be given priority of receiving antiviral treatments in order to prevent HCC;those carrying C1653T or T1753V mutation should be monitored closely to detect early HCC and receive timely surgical resection.
ABSTRACT
More than10 million people are suffering from hepatitisC virus(HCV) inPakistan.The available treatment option is a combination of interferon and ribavirin.Treatment response is linked with several factors and also induces a number of side effects.We searched inPubmed,PakMedi Net andGoogleScholar for the articles presenting the effect of interferon plus ribavirin therapy onHCV patients fromPakistan, their side effects and future prospects.The major prevalent HCV genotype inPakistan is3.Conventional interferon alpha plus ribavirin showed sustained virological response of54%-64% while pegylated interferon alpha plus ribavirin showed sustained virological response of58%-75%.IL-28BCC genotype is linked with better sustained virological response.Studies on patients withHCV genotype3 infections showed no correlation between treatment response and interferon sensitivity determining region mutations.Interferon therapy is linked with a number of side effects like thyroid dysfuncton, haematological disorders, weight loss, gastrointestinal tractside effects and neuropsychiatric side effects.Unusual side effects of clubbing of fingers and seizures were also observedin a couple of patients.Interferon alpha plus ribavirin therapy showed better response rate inHCV genotype3 patients fromPakistan with number of side effects.A couple of interferon free therapies are light of hope for the patients living withHCV.
ABSTRACT
Se describe el caso de una mujer con hepatitis C crónica diagnosticada por criterios bioquímicos, serológicose histológicos, quien presentó hepatitis autoinmune aguda y falla hepática aguda luego de un año de iniciadotratamiento con interferón pegilado, y quien requirió trasplante ortotópico de hígado
We describe the case of a woman with chronic hepatitis C which had been diagnosed by biochemical, serologicaland histological criteria. She presented acute autoimmune hepatitis and acute liver failure a year afterstarting treatment with pegylated interferon and required orthotopic liver transplantation
Subject(s)
Female , Hepatitis C , Hepatitis, Autoimmune , Interferons , Liver Failure , Liver TransplantationABSTRACT
Objective: To determine the significantly associated factors with the relapse rate in chronic hepatitis C patients treated with conventional interferon and their predictive strength through the regression model. Material & Methods: In a retrospective analysis of 244 patients, result of PCR, gender, fatty liver, diabetes, abnormal ALT at start and end of treatment were the qualitative variables. Age, weight, ALT at start and end of treatment, hemoglobin, platelets and WBC at start of treatment were quantitative variables. Bivariate, multivariate analysis and odds ratio were computed to verify statistically significant association with relapse rate by running binary logistic regression model. Results: Out of total 244 patients there were 54.1% male and 45.9% female. Eighty two (33.6%) patients had weight > 70 Kg, 30 (12.3%) had fatty liver, 18 were (7.4%) diabetic, 12 (4.9%) had normal ALT at start of therapy and 140 (57.4%) had abnormal ALT at the end. Eighty four (34.4%) patients relapsed while 160 (65.6%) maintained SVR after 6 month to 2 years of completion. In bivariate analysis, age, weight, fatty liver, high fever, decrease and increase in Hb were found significant. The binary logistic regression revealed the significant association of weight (OR=84.813; p=0.000), high fever (OR=4.478; p= 0.038) and Hb increase at 1st month (OR=0.037; p=0.013) with relapse rate. Nagelkerke R Square and Cox & Snell R Square statistics explained 71.1% and 51.1% variation in the model respectively and 93.1% area under the curve gave it very good prediction strength.
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Introduction Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection, and its occurrence may be related to both host and viral factors. Relationship between improvement in steatosis and response to anti-viral treatment remains unclear. This study assessed the factors associated with steatosis in patients infected with genotype 4 HCV, and to correlate degree of changes in steatosis with host factors and response to treatment. Methods Records of 175 patients with chronic genotype 4 HCV infection, who had received interferon and ribavirin combination therapy, were reviewed retrospectively to extract data on body mass index (BMI), presence of diabetes mellitus, and liver histology findings. Paired BMI data and liver biopsies (pre- and 24-weeks post-treatment) were available in 86 patients. Baseline steatosis and its changes (before and after treatment) were the dependent variables in a univariate and multivariate analyses. Results Steatosis was found in 88/175 (50.3%) of baseline biopsies. Its presence was related to baseline BMI (r=0.33, P<0.01), but not with viral load, or grade of liver inflammation or fibrosis. On follow up, improvement in steatosis was significantly associated with degree of weight loss but not with response to anti-viral treatment. Conclusion Steatosis is common in genotype 4 HCV infection, and its presence appears to be related to high BMI, but not to viral load or degree of liver injury.
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Chronic granulomatous disease is a group of rare disorders characterized by a disease of oxidative metabolism of phagocytes with deficit of antimicrobial activity. Also, it has clinical features of chronic pyogenic infection, granuloma formation, hypergammaglobulinemia, anemia and leukocytosis.We experienced a case of chronic granulomatous disease with chronic recurrent infection, hypergammaglobulinemia and liver abscess. It was confirmed by modified NBT test. The result of patient's NBT test was less than 11%. The patient received subcutaneous injection of interferon-gamma, 200 million unit (0.1mg/m2 of body surface area per dose), on three consecutive days per week for 3 weeks and her symptom was improved. Then, we report a case of chronic granulomatous disease which is improved by interferon- therapy with brief review of literature.