ABSTRACT
BACKGROUND/AIM: Peginterferon plus ribavirin is the treatment of choice for chronic hepatitis C (HCV). HCV genotype 4 is considered difficult to treat and data regarding the efficacy of antiviral therapy for this genotype are scanty. The aim of the study was to asses the efficacy and tolerability of fixed dose peginterferon alpha 2a plus ribavirin for the treatment of HCV genotype 4. METHODOLOGY: A prospective open label study was done on 30 middle eastern treatment naive chronic hepatitis C patients. They were treated with 180 mcg of peginterferon alpha 2a subcutaneous weekly plus oral ribavirin of 1200 mg daily if body weight > 75 kg. The treatment was continued for 48 weeks and patients were followed up for 24 weeks post-treatment. The early and sustained virological responses were were defined as the absence of HCV RNA from serum at 12 weeks and 72 weeks respectively. The data was analyzed on an intention to treat basis. RESULTS: The early and sustained virological responses were 83.3% and 63.3% respectively. The EVR in patients with minimal or absent fibrosis (96.6%). The SVR in patients with BMI =/> 25 (81.8%) were not significantly different from those of patients with BMI < 25 (87.5%) even with the fixed dose peginterferon. CONCLUSION: Peginterferon alpha 2a in combination with ribavirin is effective in the treatment of HCV genotype 4 and treatment response is intermediate between that of genotype 1 and genotype 2 or 3.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Interferon-alpha/therapeutic use , Polyethylene Glycols/therapeutic use , Ribavirin/therapeutic use , Biopsy , Chi-Square Distribution , Drug Therapy, Combination , Female , Genotype , Hepacivirus/genetics , Hepatitis C, Chronic/genetics , Humans , Interferon alpha-2 , Male , Middle Aged , Recombinant Proteins , Treatment Outcome , Viral LoadSubject(s)
Diabetes, Gestational/epidemiology , Abortion, Spontaneous/epidemiology , Adult , Asian People , Australia , China/ethnology , Diabetes Mellitus/genetics , Female , Fetal Death , Fetal Macrosomia/epidemiology , Humans , Infant, Newborn , Medical Records , Odds Ratio , Philippines/ethnology , Pregnancy , Prenatal Care , Retrospective Studies , Risk Factors , Sri Lanka/ethnology , Vietnam/ethnologyABSTRACT
A prospective study was conducted to study the splenic function among sickle cell anemia (SCA) patients in Qatif (Eastern Province of Saudi Arabia). Seventy-seven patients (30 children and 47 adults aged 2-57 years) were included. (99m)Tc stannous colloid liver-spleen scan was done for each patient during steady state. The splenic function was graded from 0 to 4 in relation to liver uptake. Seventy percent of our patients showed evidence of splenic hypofunction, and most of them (83%) had severe hyposplenism. Up to the age of 4 years, only 17% of the children showed evidence of functional hyposplenism, but by the age of 10 years >50% were hyposplenic. Most of the hyposplenic children had functional hyposplenism, whereas only one-third of hyposplenic adults had autosplenectomy. There was no effect of level of HbF on the frequency of hyposplenism, but on the other hand low MCV seems to be protective against hyposplenism. A significant number of adult SCA patients have clinically enlarged spleens, and almost a third have normally functioning spleens. Because of the low prevalence of hyposplenism in children younger than 4 years of age, routine penicillin prophylaxis is probably not indicated in this population, an issue which needs further evaluation.
