RESUMO
Sequence comparison between isolates of hepatitis C virus [HCV] indicated that HCV can be classified into a series of distinct genotypes. The aim of this study was to determine the prevalence and clinical significance of HCV genotypes, to evaluate clinical relevance of percentage of CD4+ and CD8+ T cells in blood, and to find out predictors of response to interferon [IFN] therapy in Egyptian chronic hepatitis C [CHC] patients. The present study included 61 CHC patients who were subjected to HCV-RNA detection, HCV genotyping and determination of percentage of CD4+ and CD8+ T cells in blood before and after six months treatment with IFN. Also, 20 healthy adults were enrolled as control group. Results revealed that genotype 4a is the prevalent HCV-genotype [85%] in Egypt. Only 21% of cases responded to IFN. The percentage of CD4+ T cells was significantly reduced, while the percentage of CD8+ T cells was significantly increased in patients with CHC. After IFN therapy only the percentage of CD8+ T cells was significantly reduced in non responders. Both genotype and percentage of both CD4+ and CD8+ T cells failed to predict response to IFN. It was concluded that genotype 4a is the predominant genotype in Egypt. CHC is a disease of liver which may be induced by a suboptimal immune response. Selection of CHC patients for treatment with IFN is still a controversial issue
Assuntos
Humanos , Masculino , Feminino , Hepacivirus/isolamento & purificação , Hepacivirus/genética , Linfócitos T , Subpopulações de Linfócitos T , Doença Crônica , Hepatite C/fisiopatologiaRESUMO
Sclerotherapy was performed for 19 patients with gastroesophageal varices and one with isolated gastric varcies along one to two sessions using one to 3 ampoules of Histoacryl for each varices. The efficacy of Histoacryl in obliteration of the varices either during active bleeding or elective injection was studied. Three patients with active bleeding from gastric varices were injected with Histoacryl and bleeing was successfully stopped without incidence of rebleeding. The incidence of rebleeding and/or other complications during follow-up period that ranged between 5 and 10 months [mean 7.75 +/- 1.99] were assessed. From these results it can be concluded that Histoacryl is an effective line of treatment in definitive control of acute gastric variceal bleeding, in elective obliteration of varices and in prevention of rebleeding in all patients. It has no serious complications when used by expert hands