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1.
Internist (Berl) ; 58(8): 855-858, 2017 Aug.
Article in German | MEDLINE | ID: mdl-28405696

ABSTRACT

A 35-year-old woman who had previously undergone a lung transplantation presented with severe abdominal pain and vomiting. The gastroscopy showed diffuse ulcerative gastric lesions. Tests for varicella zoster virus and Epstein-Barr virus via polymerase chain reactions (PCR) on endoscopically obtained gastric biopsies were found to be positive and confirmed varicella gastritis. Intravenous antiviral therapy with acyclovir was administered resulting in a normalization of all clinical symptoms, especially of abdominal pain and inflammation parameters.


Subject(s)
Chickenpox/diagnosis , Gastritis/diagnosis , Granulomatosis with Polyangiitis/surgery , Lung Transplantation , Acyclovir/therapeutic use , Adult , Antiviral Agents/therapeutic use , Chickenpox/complications , Chickenpox/drug therapy , Female , Gastritis/drug therapy , Gastritis/virology , Herpesvirus 3, Human , Humans , Immunocompromised Host
2.
J Viral Hepat ; 21(5): 333-40, 2014 May.
Article in English | MEDLINE | ID: mdl-24716636

ABSTRACT

Since 2011, telaprevir (TVR)-based triple therapy is the new treatment standard for hepatitis C genotype 1 virus infection. The aim of our retrospective interim analysis encompassing the first 24 weeks on TVR-based triple therapy was to assess 'real-life' antiviral efficacy and side effects in a large single-centre cohort, both in comparison with the data obtained in large prospective clinical trials. In total, we treated 102 patients: 24 treatment-naïve patients, 58 patients pretreated with PEG-IFN/RBV (thereof: 28 with nonresponse, 25 with relapse, five unknown) and 20 patients who previously had received nonpegylated interferon. 74 of 102 patients were assigned with HCV genotype 1b; 34 of 102 patients were treated in the context of liver cirrhosis. 72 of 102 patients have reached treatment week 24 (mean treatment duration 31 weeks). In the ITT analysis, overall response rates were at: week 4: 66%; week 12: 85%; and week 24: 78%. So far, 24 patients discontinued treatment prematurely, of those, 10 patients were due to virological failure. Haematological side effects were frequent (40% anaemia), as were 'flu-like' symptoms (94%), rash (65%) and pruritus (79%). According to our interim ITT analysis encompassing up to 24 weeks of TVR-based triple therapy, our 'real-life' antiviral effects are comparable to the results of large multicentric clinical trials. However, TVR-based triple therapy exhibited a high frequency of side effects requiring multiple therapeutic interventions. Notably, in our 'real-life' cohort, no lethal case was observed so far.


Subject(s)
Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Hepacivirus/isolation & purification , Oligopeptides/adverse effects , Oligopeptides/therapeutic use , Viral Load , Adult , Aged , Cohort Studies , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/methods , Drug-Related Side Effects and Adverse Reactions/epidemiology , Female , Genotype , Hepacivirus/classification , Hepacivirus/genetics , Humans , Interferons/adverse effects , Interferons/therapeutic use , Male , Middle Aged , Retrospective Studies , Ribavirin/adverse effects , Ribavirin/therapeutic use , Treatment Outcome , Young Adult
3.
Z Gastroenterol ; 52(1): 27-34, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24420796

ABSTRACT

Recurrent HCV infection post-liver transplantation (post-LT) is still a major challenge in the treatment of hepatitis C virus (HCV) infection. In this retrospective analysis we gathered data about treatment response and safety of all 14 post-LT patients who were treated between 2011 and 2013 at our centre with a telaprevir (TVR)-based triple therapy. Seven out of 14 patients completed the full treatment course of 48 weeks. Five patients achieved a SVR 24, while 3 additional HCV RNA-negative patients are still in follow-up (end of treatment, SVR 12 and 22). Four patients discontinued treatment prematurely due to side effects. A virological non-response at TW 4 was seen in 1 patient. Virological breakthrough was observed in 2 patients at TW 16 and 28, respectively; 1 patient displayed a virological relapse after the end of treatment (EOT). Patients with a complicated course post-LT accumulated most of the severe side effects, largely infections. One patient with cholestatic hepatitis died 11 weeks after discontinuation of treatment due to progressive graft failure. In conclusion, TVR-based triple therapy in post-LT patients reveals an acceptable antiviral efficacy. Unfortunately, severe side effects are frequent and often require therapeutic interventions. Therefore, with the approval of less straining DAA like sofosbuvir in sight, TVR-based triple therapy in post-LT patients should be, if possible avoided.


Subject(s)
Hepatitis C/etiology , Hepatitis C/prevention & control , Liver Transplantation/adverse effects , Oligopeptides/administration & dosage , Aged , Antiviral Agents/therapeutic use , Drug Therapy, Combination , Female , Hepatitis C/diagnosis , Humans , Male , Middle Aged , Retrospective Studies , Secondary Prevention , Treatment Outcome
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