Archive for the ‘Recurrent hepatitis C’ Category

Firpi et al treated 54 patients with recurrent HCV with standard interferon three times a week and ribavirin for 48 weeks. An ETR was achieved in 21 patients (38%) and a SVR was achieved in 16 patients (30%). Tolerability was poor and the doses of medication were modified in 72% of these patients. Other studies using the standard dose of interferon with ribavirin have reported an ETR ranging from 25% […]

Viral factors (genotype and viral load), donor factors (age and steatosis), host factors (age, sex, alcohol use and cytomegalovirus infection) and iatrogenic factors (immunosuppression) have been implicated in HCV recurrence. The clinical course of the recurrent disease is variable, ranging from mild hepatitis with a mildly elevated liver profile to the severe form of hepatitis leading to cirrhosis in 10% to 33% of patients within five years. A minority of […]

Goodpasture’s syndromeGoodpasture’s syndrome was suspected but a kidney biopsy could not be performed because of a coagulopathy. Increasing his immunosuppression did not slow the progression of his renal dysfunction and he subsequently died of hepatic and renal failure. No autopsy was performed. The only patient having cirrhosis to tolerate the therapy was patient […]

This normalized his liver biochemistry and was reasonably well-tolerated. The most serious morbidity in the series was seen in patients 9 to 13, all of whom had advanced fibrosis. Patients 9 and 11, who had previously tolerated Rebetron after LT, developed debilitating myalgias requiring the discontinuation of PEG-IFN after only two and five doses, respectively. Subsequently, both of these patients developed episodes of ACR associated with jaundice shortly after terminating […]

hemoglobinThe starting and maximum doses of ribavirin and the impact of therapy on hemoglobin levels have been shown previously. The dose of ribavirin was able to be increased in four patients; however, only three patients (23%) received doses of ribavirin greater than 1000 mg/day. Seven patients (54%) received greater than 10.6 mg/kg of ribavirin, […]

SVR was seen in four of eight patients (50%) with early-stage disease compared with none of the five patients with advanced fibrosis or cirrhosis (P=0.1). The starting and maximum doses of PEG-IFN and the impact of therapy on neutrophil and platelet counts have been shown previously. The average starting dose of PEG-IFN was 0.91 pg/kg once weekly. Dose escalation of PEG-IFN was possible in only four patients, and only two […]

PEG-IFN monotherapyTwo patients, who were switched to PEG-IFN monotherapy because of significant hemolysis on Rebetron, experienced a flare in their ALT levels after a change in their interferon. Patient 11 had his ALT level increase from 217 U/L to 439 U/L and he subsequently discontinued PEG-IFN after five weeks because of severe myalgias. […]

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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.