[Evaluation of combination therapy with interferon and ribavirin in patients with chroni hepatitis C: a genoty based study]

About 200,000 of Iranian population are infected with Hepatitis C Virus. On the basis of Iranian consensus on management of chronic hepatitis C [CHC] infection in 2004, combination therapy with conventional alpha-Interferon [IFN] plus Ribavirin is the first therapeutic choice in CHC patients. Data are limited on treatment response rate in most areas of the country. To assess the treatment results, we performed this study in a referral center in province of Fars, in Iran, to compare with the response rates to therapy in Western patients. A total of 118 patients with CHC [males 88%] with mean age of 37.47 [SD 11.4] years, mean Histologic Activity Index of 8.21 [SD 4.5], and mean pretreatment Alt level of 81.26 [SD 72.86] were enrolled in the study. IFN 3 million unit/TIW plus Ribavirin 1-1.2 gr/d were administered for 6-12 months [depending on genotype], and the patients were followed up for 6 months period to assess sustained virologic response [SVR]. The most common route of acquisition of the virus was intravenous drug using seen in 39.8% of patients. 40.7% were infected by genotype 3a, 22% 1a and 9.3% by 1b. Seventy- three patients completed the course of therapy. End of treatment response [ETR] was achieved in 54 [74%] patients. SVR rate was 48% with a relapse of 13.7%. Hepatic decompensation was seen in 2 [2.7%] patients in follow-up period. With respect to the duration of therapy, genotype of viruses was not significantly different in both responders and non-responders [0.05]. Despite the different genotyping pattern ETR and SVR rates were comparable in Iranian CHC patients treated by combination therapy of conventional IFN plus ribavirin in comparison with Western patients. SVR was greater in cases with pretreatment lower HAI

Biliary tract obstruction due to Fasciola hepatica managed by ERCP

Fascioliasis is a health problem in several countries including the Islamic Republic of Iran. In a review of the medical publications during 1990-2002, only 22 cases of biliary tract obstruction by fasciola hepatica have been reported. Herein, we are adding a new case of fasciola hepatica causing bile duct obstruction and presenting with intermittent colicky pain, eosinophilia and bile duct dilatation. This condition was diagnosed by endoscopic retrograde cholaogiopancreatography [ERCP] and was treated by extemporaneous papillotomy. This case report confirms that in endemic areas, fascioliasis should be included in the list of the differential diagnosis for colicky abdominal pain, eosinophilia and bile duct dilatation. The condition could be concurrently diagnosed and treated by ERCP