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[Treatment of naive patients with chronic hepatitis C].

According to published data, 60% of hepatitis C virus (HCV)-infected patients in Croatia have HCV genotype 1. The second most common genotype is 3a (36%). Standard treatment regimen for patients with chronic hepatitis C is a combination of pegylated interferon alfa (2a or 2b) with ribavirin, in duration guided by genotype: patients with genotype 1 are treated for 48 weeks and patients with genotypes 2 and 3 for 24 weeks in order to achieve virus elimination defined as HCV RNA undetectability 24 weeks after the treatment period (SVR). These treatment regimens fail to achieve SVR in 50% of patie…

Virology and pathogenesis of hepatitis C virus recurrence.

1. In hepatitis C virus (HCV)-infected patients undergoing liver transplantation (LT), the virus infects the liver graft immediately after transplantation. The main source of HCV infection is circulating virions. Nevertheless, some data suggest that HCV present in extrahepatic compartments may contribute to HCV infection in some cases of hepatitis C recurrence. 2. Studies on early kinetics have shown that HCV replication starts a few hours after transplantation and that HCV-RNA concentrations increase a few hours or days after the procedure, suggesting that HCV has an enormous ability to adapt…

Emerging therapeutic strategies for hepatitis C virus infection.

The universal prevalence of hepatitis C virus (HCV) infection, which causes chronic hepatitis, cirrhosis, liver failure, and hepatocellular carcinoma, has become a significant health problem worldwide. Interferon-based therapies, the current standard, IFN-based therapies have limited efficacy and undesirable adverse effects. In addition, neither vaccination against HCV nor specific antiviral reagents for HCV are yet available. Thus, a major medical need still exists for novel and more efficacious anti-HCV reagents showing broad-spectrum clinical efficacy with enhanced tolerability. With the pr…

Cryofibrinogen in patients with hepatitis C virus infection.

BACKGROUND: Mixed cryoglobulin is usually associated with hepatitis C virus (HCV) infection and might cause systemic vasculitis. The presence and impact of cryofibrinogen, another cryoprotein, in the serum of HCV-infected patients have not yet been evaluated. The objective was to study the prevalence and the clinical and therapeutic impacts of cryofibrinogen in HCV-infected patients. METHODS: A total of 143 consecutive HCV-infected (RNA+) patients (including 57 patients with HCV-related vasculitis) were screened for cryofibrinogen and cryoglobulin (positive if >0.05 g/L). The main characteris…

Prevention of viral hepatitis (B and C) reassessed.

As hepatitis B and C share modes of transmission, their combined occurrence is not uncommon, particularly in areas where both viruses are en … is hampered, and increasing efforts are required to eliminate acute and chronic hepatitis B. Unlike hepatitis C and HIV, HBV has not captured sufficient attention from policymakers, advocacy groups, or the general public: a major challenge for the future. Although progress has been made in the development of an hepatitis C vaccine, short-term successes are no …

Острый гепатит С: нынешнее положение дел и сохраняющиеся проблемы.

Острая фаза заражения вирусом гепатита С (ГХВ) является ключевым моментом в эволюции гепатита С. У некоторых пациентов инфекция решается спонтанно, в то время как в других она превращается в хроническую болезнь. Однако, поскольку острый гепатит С часто носит асимптомический характер, обнаружение и диагностика, как правило, сопряжены с трудностями. Более того, не существует установленных руководящих принципов лечения, в соответствии с которыми врачи могут принимать несколько трудных решений, таких, как: лечить, когда лечить и какой режим лечения следует применять. Пегилизованная интерферон-альф

Совпадение в аннотации оригинала
The acute phase of hepatitis C virus (HCV) infection represents a key point in the evolution of hepatitis C. In some patients, the infection resolves spontaneously, whereas in others it develops into chronic disease. However, because acute hepatitis C is often asymptomatic, detection and diagnosis are usually difficult. What is more, there are no established…

[Steatosis, chronic hepatitis virus C infection and homocysteine].

Homocysteine, a sulfuric amino acid involved in methionine metabolism, belongs to the group of intracellular thiols. Hyperhomocysteinemia is … s have suggested a discriminating threshold to differentiate simple steatosis from NASH. In chronic hepatitis C, preliminary data have shown that hyperhomocysteinemia is an independent risk factor for steatosis or even fibrosis. The physiopathological mechanism has now begun to be better understood. On one hand, there is a strong correlation between homocyste …

Specifically targeted antiviral therapy for hepatitis C virus.

Hepatitis C virus (HCV) infection affects 180 million people worldwide with the predominant prevalence being infection with genotype 1, followed by genotypes 2 and 3. Standard anti-HCV therapy currently aims to enhance natural immune responses to the virus, whereas new therapeutic concepts directly target HCV RNA and viral enzymes or influence host-virus interactions. Novel treatment options now in development are focused on inhibitors of HCV-specific enzymes, NS3 protease and NS5B polymerase. These agents acting in concert represent the concept of specifically targeted antiviral therapy for H…

Antibody-dependent enhancement of hepatitis C virus infection.

Hepatitis C virus (HCV) often causes a persistent infection associated with hypergammaglobulinemia, high levels of antiviral antibody and circulating immune complexes, and immune complex disease. We previously reported that only a limited neutralizing activity to vesicular stomatitis virus or HCV pseudotype is generated in animals immunized with recombinant HCV envelope proteins and chronically infected HCV patient sera. Interestingly, when some of these neutralizing sera were diluted into a range of concentrations below those that reduced virus plaque number, an increase in pseudotype plaque …

Hepatitis C in dialysis units: the Saudi experience.

Hepatitis C virus (HCV) infection is a significant health problem, as it can lead to chronic active hepatitis, liver cirrhosis, and hepatic carcinoma. Patients undergoing hemodialysis treatment are at increased risk of contracting HCV and other viral infections. This is primarily due to their impaired cellular immunity, underlying diseases, and blood exposure for a prolonged period. Transmission of viral hepatitis, and in particular HCV in dialysis units, has been showing a progressive increase worldwide, ranging between 5% in some western countries and up to 70% in some developing countries. …

Cognitive dysfunction in chronic hepatitis C: a review.

The hepatitis C virus (HCV) is a common blood-borne illness that affects up to 2% of the world's population and almost 4 million Americans. Cognitive impairment, or difficulty with thinking, has become a well-established symptom in persons with end stage liver disease. It was previously assumed that cognitive impairment was a consequence of cirrhosis-associated hepatic encephalopathy. Recent evidence, however, suggests that approximately one-third of people with chronic HCV experience cognitive impairment even in the absence of cirrhosis and that its occurrence is unrelated to other indices of…

[Update in Hepatitis C virus associated extrahepatic manifestations].

INTRODUCTION: Since the discovery of the hepatitis C virus, many manifestations, so called extra-hepatic manifestations (EHM), are largely reported with more or less relationship proofs. ACTUALITIES AND MAIN POINTS: This article proposes a review of the main extra-hepatic manifestations associated with the Hepatis C Virus infection and which remain a topical subject, more than fifteen years after the discovery of this virus. Mixed cryoglobulin and its vasculitic manifestations are still one of the more frequent Hepatis C Virus associated-extra-hepatic manifestations. Its management may be cri…

Anti-C1q antibodies in hepatitis C virus infection.

Autoantibodies against C1q have been described in many immune-complex diseases including hypocomplementaemic urticarial vasculitis and systemic lupus erythematosus (SLE). No study has focused on the role of anti-C1q antibodies in hepatitis C virus (HCV) infection. The aim of this study was (i) to evaluate the prevalence of anti-C1q antibodies in HCV infection; and (ii) to analyse the association of anti-C1q antibodies with clinical and biological features of HCV-mixed cryoglobulinaemia (MC) vasculitis. We searched for anti-C1q antibodies using an enzyme-linked immunosorbent assay (ELISA) test …

Acute viral hepatitis C-induced jaundice in pregnancy.

OBJECTIVE: Acute viral hepatitis C-induced jaundice in pregnancy is very rare and may be fatal. Here, we report a complicated case with acute hepatitis C-induced jaundice in pregnancy with successful management. CASE REPORT: A 27-year-old pregnant woman, gravida 2, para 1, with gestational age of 36 weeks and 5 days, was referred to our hospital due to jaundice and elevated liver enzymes of undetermined cause. She had been suffering from general weakness, diarrhea and vomiting for 1 week, and jaundice with tea-colored urine for 3 days. At our medical center, acute viral hepatitis C-induced ja…

[Epidemiology of hepatitis B and C in Croatia].

The incidence of HBV and HCV infection is hard to determine because of the high number of asymptomatic infections. According to data of the … anti-HCV) in the Croatian general population is more than 1% and the number of yearly infected with hepatitis C reported to the Croatian Institute of Public Health is around 200 cases. The highest incidence is found in the 20-40 age groups at a high risk of infection by the use of drug injection. At risk are persons who received transfusion of blood or blood …

Acute hepatitis C in a nursing home resident.

Elderly patients commonly present with jaundice from a multitude of causes. We present an unusual case of acute hepatitis C in an elderly nursing home resident who had no risk factors. Possible causes and treatment are discussed.

Prevalence of hepatitis C virus among bilharziasis patients.

OBJECTIVE: Hepatitis C virus (HCV) infection with concurrent Schistosoma mansoni infestation has emerged as a major cause of chronic liver disease and liver cirrhosis. The aim of this study was to investigate the prevalence of HCV among bilharzia patients. METHODS: The study was conducted at the Viral Diagnostic and Parasitology Departments, Regional Laboratory and Blood Bank, Dammam, Kingdom of Saudi Arabia from August 1999 to July 2000. Sera from a total of 405 patients, including 356 Saudi nationals and 49 non-Saudis, who had a clinical suspicion of bilharziasis were tested, using enzyme l…

Hepatitis C virus and lichen planus: a review.

INTRODUCTION: The relationship between hepatitis C virus (HCV) infection and oral lichen planus (OLP) remains a matter of controversy. It is important to determine whether there is an association between OLP and HCV infection so that guidelines regarding the routine HCV testing of patients with OLP can be developed for clinicians. OBJECTIVES: The objective of this article was to review and summarize the published literature on the association between OLP and HCV and to describe future directions. METHODS: A search of the computerized database MEDLINE (1966-June 2003) was conducted. The bibli…

Hepatitis C: How should we manage the patient?

The patient with HCV infection may present with a variety of problems and range from the asymptomatic patient with mild liver damage to a patient presenting with complications of cirrhosis or hepatocellular carcinoma. The diagnosis of hepatitis C may be a complete surprise to the patient or be an expected diagnosis in someone with known risk factors. Similarly the physician may be faced with a patient who knows very little about hepatitis C or someone who has read extensively on the subject. The initial consultation is useful for gaining information on the patient's background, physical examin…