ABSTRACT
ABSTRACT Background: To analyze the effectiveness and the safety of Sofosbuvir-based regimens to treat patients with chronic hepatitis C virus (HCV) infection and chronic kidney disease (CKD). Methods: A retrospective, observational study in patients with chronic HCV infection and CKD treated with Sofosbuvir-based regimens was performed. Liver fibrosis, comorbidities, HCV genotype and sustained virological resposnse (SVR) at 12th week post-treatment were evaluated. Kidney function was accessed by serum creatinine and glomerular filtration rate (GFR). The assumed level of significance was 5 %. Results: Thirty-five patients were treated. The mean age was 52.1 ± 10.9 years, 19 (54.3 %) were women, 32 (91.4 %) were already kidney transplanted and 3 (8.6 %) were on hemodialysis. The SVR by intention to treat was 88.6 %. The mean GFR was 65.8 ± 28.6 and 63.7 ± 28.3 ml/min pre- and post-treatment respectively (p > 0.05). Treatment was interrupted in 1 (2.85 %) patient due to anemia and in 2 (5.7 %) due to loss of kidney function. Conclusion: Sofosbuvir-based regimens are effective to treat HCV in patients with CKD. In patients with mild CKD this type of therapy seems to be safe.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Renal Insufficiency, Chronic/physiopathology , Sofosbuvir/therapeutic use , Severity of Illness Index , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Kidney Transplantation , Treatment Outcome , Statistics, Nonparametric , Creatinine/blood , Renal Insufficiency, Chronic/therapy , Sustained Virologic Response , Glomerular Filtration Rate , Imidazoles/therapeutic use , Immunosuppressive Agents/therapeutic useABSTRACT
BACKGROUND: To analyze the effectiveness and the safety of Sofosbuvir-based regimens to treat patients with chronic hepatitis C virus (HCV) infection and chronic kidney disease (CKD). METHODS: A retrospective, observational study in patients with chronic HCV infection and CKD treated with Sofosbuvir-based regimens was performed. Liver fibrosis, comorbidities, HCV genotype and sustained virological resposnse (SVR) at 12th week post-treatment were evaluated. Kidney function was accessed by serum creatinine and glomerular filtration rate (GFR). The assumed level of significance was 5 %. RESULTS: Thirty-five patients were treated. The mean age was 52.1±10.9 years, 19 (54.3 %) were women, 32 (91.4 %) were already kidney transplanted and 3 (8.6 %) were on hemodialysis. The SVR by intention to treat was 88.6 %. The mean GFR was 65.8±28.6 and 63.7±28.3ml/min pre- and post-treatment respectively (p>0.05). Treatment was interrupted in 1 (2.85 %) patient due to anemia and in 2 (5.7 %) due to loss of kidney function. CONCLUSION: Sofosbuvir-based regimens are effective to treat HCV in patients with CKD. In patients with mild CKD this type of therapy seems to be safe.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/drug therapy , Renal Insufficiency, Chronic/physiopathology , Sofosbuvir/therapeutic use , Adult , Aged , Analysis of Variance , Carbamates , Creatinine/blood , Female , Glomerular Filtration Rate , Humans , Imidazoles/therapeutic use , Immunosuppressive Agents/therapeutic use , Kidney Transplantation , Male , Middle Aged , Pyrrolidines , Renal Insufficiency, Chronic/therapy , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Statistics, Nonparametric , Sustained Virologic Response , Treatment Outcome , Valine/analogs & derivativesABSTRACT
Chronic Hepatitis C relapse after liver transplantation can lead to graft failure within a short time period. The high efficacy and good safety profile of direct-acting antivirals has led to consensual recommendations for using interferon-free treatment after liver transplantation. However, pegylated interferon may still be required for genotype 3 non-responders. We treated a liver graft recipient with grade 1 fibrosis in the biopsy with daclatasvir and sofosbuvir for 12 weeks. He did not respond and progressed to grade 3 fibrosis. Lacking other options, we obtained a sustained virological response with pegylated interferon, ribavirin and sofosbuvir for 12 weeks. The combination of pegylated interferon, ribavirin and sofosbuvir is a viable option after the failure of direct acting antivirals in economically disadvantaged countries.
Subject(s)
Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , Interferon alpha-2/administration & dosage , Interferon-alpha/administration & dosage , Polyethylene Glycols/administration & dosage , Ribavirin/administration & dosage , Sofosbuvir/administration & dosage , Aged , Drug Therapy, Combination , Genotype , Hepacivirus/genetics , Humans , Liver Transplantation , Male , Recombinant Proteins/administration & dosage , Viral LoadABSTRACT
A síndrome de Miller Fisher (SMF), uma variante da Síndrome de Guillain-Barré, é uma doença incomum na prática médica. Esta doença é caracterizada por inflamação e desmielinização dos nervos periféricos de provável causa infecciosa. Estão descritos casos associados a infecções respiratórias e digestivas. O presente relato descreve o caso de uma paciente de 54 anos que apresentou SMF após sete dias de infecção urinária por Escherichia coli.
Miller Fisher syndrome (MFS), a variant of Guillain-Barré syndrome, is an uncommon disease in medical practice. It is characterized by inflammation and demyelination of peripheral nerves of probable infectious etiology. Cases are associated with respiratory and digestive infections. This report describes the case of a 54-year-old female patient who presented with MFS after seven days of urinary tract infection with Escherichia coli.
