Long-term follow up of Egyptian patients with chronic hepatitis c: impact of interferon therapy on their outcome - with special reference to HCC

To our knowledge no previous data worldwide investigated the effects of interferon therapy in the treatment of hepatitis C virus [HCV] for longer than two years. So, this study was conducted to address the longer-term [3.5 years] Group II: 59 patients, chronic HCV with no cirrhosis, [interferon group-I] received interferon 3MIU every other day for 6 months. 57 patients completed the interferon therapy as 2 patients excluded during interferon therapy.outcomes of clinical, virological, biochemical and clinical responses to interferon therapy and the change in incidence of hepatocellular carcinoma [HCC] and other HCV-related complications in-patients with chronic hepatitis C with and without liver cirrhosis. 139 patients in our study were classified into 4 groups: Group I: 20 patients, chronic HCV with no cirrhosis, [control group-1] received silymarin 70 mg thrice daily for 3.5 years. Group III: 20 patients, chronic HCV with cirrhosis, [control group-2] received silymarin 70mg thrice daily for 3.5 years. Group IV: 40 patients, chronic HCV with cirrhosis, [interferon group-2] received interferon 3MIU every other day. for 6 months. Evaluation of our patients during the study period was based on the followings: 1] Response at the end of interferon therapy and 3 years after interferon withdrawal. 2] Incidence of liver decompensation. 3] Incidence of portal hypertension 4] Incidence of gastrointestinal bleeding. 5] Incidence of hepatocellular carcinoma. 1- Interferon alpha is effective in chronic hepatitis C and 49% of patients obtain a sustained benefit [long-term responders]. 2-The sustained response to interferon therapy in patients with chronic hepatitis C with cirrhosis is 0% after 3 years of stop interferon. 3-Interferon therapy significantly reduces the risk of developing portal hypertension, ascites and hepato-cellular carcinoma in patients with HCV cirrhosis irrespective of the virological response to interferon. - Early treatment of patients with chronic hepatitis C before reaching the stage of cirrhosis.- Proper selection of patient who is candidate for interferon therapy to increase the response rate. Cirrhosis should not be considered a reason for excluding patients with HCV- related liver disease from interferon therapy

Endoscopic variceal ligation versus sclerotherapy short term effect on kidney function

One hundred patients with liver cirrhosis and history of bleeding esophageal varices were equally divided into two groups. The first group underwent variceal injection sclerotherapy and the second group underwent variceal band ligation. The effect of either procedure on hemolysis and kidney functions were studied. Serum bilirubin, LDH, end creatinine and the percentage of cases who developed hematuria were significantly increased after injection sclerotherapy and creatinine clearance significantly decreased. Renal dysfunction and hematuria were significantly lower in variceal ligation group versus sclerotherapy group. Renal dysfunction and hematuria following sclerotherapy were significnatly more when serum albumin level was below 3 g/dl