ABSTRACT
BACKGROUND: Sustained virological response rates of up to 52% have been obtained with peginterferon alpha2a (40 kDa) plus ribavirin in patients suffering from chronic hepatitis C genotype 1 in randomized-controlled trials. AIM: To assess early virological response and its clinical utility in predicting an sustained virological response in patients suffering from chronic hepatitis C genotype 1 in routine clinical practice in Spain. METHODS: Treatment-naïve patients received pegylated interferon alpha2a (40 kDa) 180 microg/week plus ribavirin 1000/1200 mg/day for 48 weeks, and were followed for a further 24 weeks. Overall, 475 patients received at least one dose of medication and were included in the efficacy population. RESULTS: The overall sustained virological response rate was 48%. Of those with week 12 virological data, 83% had an early virological response. The negative predictive value of an early virological response was 93%. CONCLUSION: If sustained virological response is the goal, a treatment-decision based on a 12-week evaluation during routine clinical practice is feasible.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Interferon-alpha/therapeutic use , Polyethylene Glycols/therapeutic use , Ribavirin/therapeutic use , Adult , Antiviral Agents/pharmacokinetics , Drug Therapy, Combination , Female , Hepatitis C, Chronic/virology , Humans , Interferon alpha-2 , Interferon-alpha/pharmacokinetics , Male , Middle Aged , Polyethylene Glycols/pharmacokinetics , Recombinant Proteins , Ribavirin/pharmacokinetics , Treatment OutcomeABSTRACT
The liver is frequently involved by amyloidosis, but hyperbilirubinemia and liver failure are uncommon features. A mild elevation of the serum alkaline phosphatase value and, less frequently, hepatomegaly are the most common findings. Usually the patients have no symptoms related with the liver involvement; the clinical manifestation and the long term prognosis depends on the renal and cardiac disease. We report an unusual clinical presentation of primary amyloidosis in a previously asymptomatic 65 years old woman who was admitted to the hospital because of ictericia and ascitis mimicking a drug induced acute hepatic failure.
Subject(s)
Amyloidosis/complications , Cholestasis, Intrahepatic/etiology , Liver Diseases/complications , Liver Failure, Acute/etiology , Aged , Female , Humans , Severity of Illness IndexABSTRACT
El hígado suele verse afectado en la amiloidosis sistémica; sin embargo, la hiperbilirrubinemia y los signos de fallo hepático son manifestaciones muy poco comunes. Una elevación ligera de las cifras de fosfatasa alcalina y, menos frecuentemente, la existencia de hepatomegalia son los hallazgos más habituales. Generalmente, los pacientes no refieren manifestaciones clínicas relacionadas con la afectación hepática; las manifestaciones clínicas y el pronóstico a largo plazo dependen de la existencia de afectación renal y cardíaca. Comunicamos un caso de amiloidosis primaria con una presentación clínica poco usual, en una mujer de 65 años de edad, que fue ingresada por un cuadro de ictericia, ascitis y fallo hepático agudo atribuído a hepatitis inducida por fármacos (AU)
