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1.
China Pharmacy ; (12): 979-985, 2021.
Article in Chinese | WPRIM | ID: wpr-876269

ABSTRACT

OBJECTIVE:To evaluate the cost-utility of the pan-genotypic direct-acting antivirals (DAAs)in the treatment of patients with chronic hepatitis C infection ,and to provide pharmacoeconomic evidence for relevant health care decisions. METHODS:A Markov model was established from a societal perspective with newly diagnosed chronic hepatitis C patients in China as the target population ,and analyzed quality-adjusted life years (QALYs)and incremental cost-utility ratios (ICERs)of patients with chronic hepatitis C with sofosbuvir/velpatasvir ,glecaprevir/pibrentasvir,sofosbuvir+coblopasvir. Sensitivity analysis was used to verity the robustness of the results. RESULTS :Glecaprevir/pibrentasvir increased QALYs by 0.002 1 and costs by 25 021 RMB,compared to sofosbuvir/velpatasvir ;its ICERs was 12 129 031 yuan/QALY(willingness to pay threshold was 70 892 yuan/QALY),which had no cost-utility ;glecaprevir/pibrentasvir need to cut down the price by 64.65% to have cost-utility. Sofosbuvir+coblopasvir increased QALYs by 0.002 0 and saved costs by 515 yuan,so it was the optimal regimen which was cost-saving. Sensitivity analysis showed that SVR rates and drug prices were the most influential factors. The probability of having cost-utility for sofosbuvir+coblopasvir was higher than glecaprevir/pibrentasvir. CONCLUSIONS :Glecaprevir/pibrentasvir need to reduce the price to achieve better affordability. Sofosbuvir+coblopasvir shows economical advantage.

2.
Br J Med Med Res ; 2014 Dec; 4(36): 5715-5728
Article in English | IMSEAR | ID: sea-175790

ABSTRACT

Arteriosclerosis is a chronic inflammatory vascular pathology that features a leading cause of coronary artery disease contributing to significant mortality and reduced quality of life. The recent identification of the possible role of infections in the initiation of a serious of inflammatory events represents an interesting development towards the better understanding of immune mediated vascular injury and premature atherosclerosis in patients with chronic HCV infection. A number of factors related to chronic HCV infection have been hypothesized to contribute to arteriosclerosis. The current review displays some of the aspects of interaction between the chronic viral infection, the immune system and cytokine networks and its relation to the increased risk of coronary artery disease.

3.
Radiol. bras ; 44(3): 141-146, maio-jun. 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-593331

ABSTRACT

OBJETIVO: Avaliar a contribuição da ultrassonografia no estudo das alterações histopatológicas encontradas na hepatite crônica pelo vírus C, com ênfase para a esteatose hepática. MATERIAIS E MÉTODOS: Foram comparados os resultados dos exames ultrassonográficos do fígado de 192 pacientes portadores de hepatite crônica pelo vírus C, com os achados histopatológicos dos fragmentos obtidos por biópsia hepática. Todos os exames ultrassonográficos obedeceram a um mesmo protocolo, sendo analisados os seguintes critérios: ecogenicidade, ecotextura e atenuação. Os pacientes foram agrupados considerando-se os com alterações ultrassonográficas e os sem alterações ultrassonográficas, sendo comparados com as alterações histopatológicas presentes. RESULTADOS: Entre as alterações histopatológicas presentes, apenas os graus 0 e 3 de alteração arquitetural e a esteatose hepática apresentaram diferença estatística significante entre os dois grupos. Dentre os critérios ultrassonográficos avaliados, a atenuação foi o que apresentou melhor correlação com a esteatose hepática. CONCLUSÃO: Os resultados do trabalho demonstraram que, em pacientes com hepatite crônica pelo vírus C, a ultrassonografia apresentou limitações à caracterização das alterações histopatológicas, apresentando concordância regular com o diagnóstico de esteatose hepática. Destaca-se a capacidade do método em mostrar a probabilidade de inexistência de esteatose hepática, tendo em vista a especificidade de 77,9 por cento e o valor preditivo negativo de 95,5 por cento.


OBJECTIVE: To evaluate the role of ultrasonography in the assessment of histopathological changes in patients with chronic hepatitis C, with emphasis on hepatic steatosis. MATERIALS AND METHODS: Liver ultrasonography results were compared with histopathological findings of liver biopsy of 192 patients with chronic hepatitis C virus infection. All the US examinations followed a single protocol, analyzing the following aspects: echogenicity, echotexture and attenuation. The patients sample was divided into two groups as follows: patients with sonographic changes and patients with no sonographic changes. Sonographic findings of both groups were compared with histopathological findings after liver biopsy. RESULTS: Statistically significant intergroup differences were observed just regarding architectural changes grades 0 and 3 and hepatic steatosis. Attenuation was the sonographic criterion that was best correlated with hepatic steatosis. CONCLUSION: The results of the present study demonstrate that, in patients with chronic hepatitis C, ultrasonography has limitations in the characterization of histopathological changes, with an intermediate rate of agreement with the diagnosis of hepatic steatosis. Considering the specificity of 77.9 percent and the negative predictive value of 95.5 percent, the authors highlight the capacity of the method to demonstrate the probability of absence of hepatic steatosis.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Fatty Liver , Fatty Liver/pathology , Hepatitis C, Chronic , Biopsy , Liver/pathology , Hepatitis C, Chronic/diagnosis
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