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1.
J Viral Hepat ; 22(8): 671-4, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25573496

RESUMO

The basis of hepatitis C virus (HCV) evasion of immune system and its response to treatment is still elusive. There have been studies where the level of C4 has been found to be associated with HCV persistence and disease progression. This study aims to find out relationship between levels of C4 in serum, and its functional SNPs with response to treatment. The study included 84 patients with CHC who received treatment and 75 healthy controls. C4 expression, both at mRNA and protein level, was estimated by Real time and ELISA respectively. Its functional SNP's genotyped by AS-PCR. The mean ± SD baseline C4 levels between the disease and healthy cases was significantly different (1075.74 ± 65.25 vs 1593 ± 24.55 ng/mL, P < 0.001). The mean ± SD baseline C4 levels of CC, GC and GG genotype of rs2857009 in the healthy group were 1540.97 ± 7.87, 1599.53 ± 11.75 and 1604.86 ± 10.79 ng/mL, respectively (P < 0.001), whereas the levels in the CHC group were 1022.81 ± 32.95, 1058.19 ± 55.02 and 1150.26 ± 14.64 ng/mL, respectively (P < 0.001). CC genotype resulted in decreased C4 mRNA levels compared to GG genotype in healthy group (3.81-fold) and CHC group (1.4-fold). The CC genotype of rs2857009 is associated with reduced expression of C4, both at mRNA and protein level. The C4 serum level at baseline and total protein were found to be independent predictors for treatment response. New predictive score using the above factors, a value of ≥ 0.542 was found to predict positive response to treatment. Increased age, rs2857009 SNP and HCV genotype were associated with disease progression.


Assuntos
Complemento C4/análise , Complemento C4/genética , Hepatite C Crônica/imunologia , Hepatite C Crônica/patologia , Polimorfismo de Nucleotídeo Único , Adulto , Fatores Etários , Antivirais/uso terapêutico , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Feminino , Perfilação da Expressão Gênica , Técnicas de Genotipagem , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/genética , Humanos , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Resultado do Tratamento
2.
J Viral Hepat ; 22(2): 184-91, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24995942

RESUMO

The basis of response of chronic hepatitis C (CHC) patients to treatment is still unclear, and there may be many other factors which influence treatment outcome other than the existing ones. The serum concentration of C3 closely reflects the total complement activity, and individuals affected by C3 deficiency suffer from recurrent pyogenic infections. This study aims to find out relationship between levels of C3 in serum and its functional SNPs with response to treatment. The study included 132 CHC patients of which 48 received Pegylated IFN+Ribavirin and 81 controls. C3 levels and its three known functional SNP's genotyped by ELISA and SSP PCR, respectively. C3 Level of the healthy group was significantly higher (88.5 ± 19 mg/dL) when compared to CHC group (56 ± 18 mg/dL; P < 0.001). Thirty-three of 36 responders were rs2230201 CC genotype carriers, whereas 9 of 12 nonresponders were non-CC genotype. The 'C' allele of rs2230201 was found to be associated with increased serum C3 levels when compared to other genotypes in healthy group, whereas CT genotype was associated with lowered serum C3 in CHC group. A serum C3 value of <53 mg/dL was predictive of SVR with sensitivity 63.89% and specificity 66.67%. The study supports the observation that rs2230201 'C' allele is associated with increase of serum C3 levels when compared to 'T' allele which may confer advantage in attaining SVR when present in homozygous condition. The study suggests that patients with serum C3 value <53 mg/dL and non-CC genotypes may not respond to treatment.


Assuntos
Antivirais/uso terapêutico , Complemento C3/genética , Complemento C3/imunologia , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/imunologia , Polimorfismo de Nucleotídeo Único , Adulto , Complemento C3/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Frequência do Gene , Genótipo , Técnicas de Genotipagem , Humanos , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Ribavirina/uso terapêutico , Soro/química , Resultado do Tratamento , Adulto Jovem
3.
Int J Qual Health Care ; 12(4): 331-7, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10985272

RESUMO

OBJECTIVE: The development and application of a questionnaire that eventually could be used as a management tool and a means of promoting the quality of care provided in 'P. & A. Kyriakou' Children's Hospital. DESIGN: Parents' survey; during treatment of their children. SETTING: 'P. & A. Kyriakou' Children's Hospital, Athens, Greece. PARTICIPANTS: Sample of 240 parents. MAIN OUTCOME MEASURE: Parent satisfaction. RESULTS: The most important finding of the study, although normative statements cannot be made, appears to be signalling of low satisfaction with care. The general mean observed (45 on a scale of 100) is not close to the mean (76) derived from a systematic review of 221 satisfaction studies. Moreover, satisfaction appears to be very low (14/100) for the procedures of the hospital, low for the outpatient dimension (42/100) and rather satisfactory for the inpatient dimension (61/100). CONCLUSION: Data-based feedback as a management tool has been associated with improved organizational functioning. However, systematic use of this intervention within Greek hospitals has been limited. Therefore, the next phase of the project will be used as feedback to the Governing Board and the personnel of the hospital. Finally, a study will be planned to investigate the effects of implementing changes based on parents' ratings of staff performance.


Assuntos
Hospitais Pediátricos/normas , Pais/psicologia , Satisfação do Paciente , Garantia da Qualidade dos Cuidados de Saúde , Inquéritos e Questionários/normas , Adulto , Análise de Variância , Criança , Criança Hospitalizada , Coleta de Dados/métodos , Análise Fatorial , Retroalimentação , Grécia , Hospitais Pediátricos/organização & administração , Humanos , Dinâmica não Linear , Inovação Organizacional , Valor Preditivo dos Testes , Gestão da Qualidade Total/organização & administração
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