ABSTRACT
BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) impairs glucose homoestasis, thus influences its clinical picture and prognosis. This study aimed at evaluating Diabetes mellitus (DM) on Egyptian patients with chronic hepatitis C (CHC), and its impact on their virologic response when treated with directly acting antiviral (DAA) medications. PATIENTS AND METHODS: Adult patients with CHC were divided into 2 groups; Diabetic patients, and Non diabetic patients serving as control group. All patients were subjected to thorough clinical evaluation, basic biochemical laboratory tests including fasting blood glucose/glycosylated haemoglobin (HbA1C), and virologic assay. They were treated with various combined DAAs, and were monitored during, at and after end of treatment. RESULTS: Diabetic patients constituted 9.85 % of CHC, and had generally worse laboratory tests (significantly higher transaminases, platelet count, Fib4 and hepatic steatosis) than non diabetic patients, and a less sustained virologic response (SVR) (significantly in Sofosbuvir (SOF) + pegylated interferon (PegIFN) + ribavirin (RBV), SOF + RBV, SOF + daclatasvir (DAC)). Although DM did not play a significant influence on SVR, yet Fib4 and SOF + RBV + PEG-IFN were significant factors affecting SVR among diabetics, while female gender and viraemia were significant factors affecting SVR among non diabetics. Hepatic fibrosis and SOF/RBV significantly influenced SVR in both groups. CONCLUSIONS: Diabetic patients with CHC have worse liver biochemical profile, yet DM per se did not influence the virologic response to DAAs, however, some factors played roles in affecting SVR among them.
Subject(s)
Antiviral Agents , Carbamates , Drug Therapy, Combination , Hepatitis C, Chronic , Imidazoles , Pyrrolidines , Sustained Virologic Response , Humans , Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/blood , Female , Male , Middle Aged , Adult , Pyrrolidines/therapeutic use , Imidazoles/therapeutic use , Carbamates/therapeutic use , Valine/analogs & derivatives , Valine/therapeutic use , Ribavirin/therapeutic use , Sofosbuvir/therapeutic use , Egypt , Glycated Hemoglobin/metabolism , Glycated Hemoglobin/analysis , Diabetes Mellitus/drug therapy , Hepacivirus/genetics , Blood Glucose/metabolism , Blood Glucose/analysis , Interferon-alpha/therapeutic use , Case-Control Studies , Polyethylene Glycols/therapeutic useABSTRACT
Intestinal capillariasis has been reported in Egypt in 1989. Since that time, 44 cases have been diagnosed. Most of the detected cases were females (37), while males were only 7. Their ages ranged from 10 to 65 years, however most of them were between 20 to 40 years. Twenty-six cases were from the northern part of Upper Egypt, particularly Bani-Suif and El-Menia Governorates. Patients presented with borborygmi, chronic diarrhea, vomiting, loss of weight, lower limb edema and electrolyte imbalance for durations ranging from one month to two years. Morbidity and mortality of the disease in Egyptian cases are described. Some patients gave history of eating raw whole fish, while others gave history of eating raw parts of fish or half-cooked fish. Diagnosis was based on the clinical picture, and confirmed stool analysis. Differential diagnosis was discussed and the cost paid by patients to reach the correct diagnosis was estimated. Suggestions about the way with which the parasite was introduced and maintained in Egypt were mentioned.