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Search Results: 1 - 10 of 14165 matches for " chronic; direct antiviral agents "
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Research progress in the development of direct acting antiviral agents for hepatitis C and the anti-viral resistance
Song YANG,Jun CHENG
Medical Journal of Chinese People's Liberation Army , 2011,
Abstract: Recently,directly acting antiviral agents against hepatitic C virus with different mechanisms have been developed and put into clinical trials.Especially,results of phase Ⅲ clinical trials of Boceprevir and Telaprevir have been published,and these two agents are to be approved for marketing in recent years.Also much attention has been paid on anti-viral resistance against direct acting antiviral agents.Great progresses have been made in field of direct acting antiviral agents against hepatitic C virus.Domestic studies in this area should take characteristics of virus and host of Chinese chronic hepatitis C into consideration.
Analysis of the sustained virological response in patients with chronic hepatitis C and liver steatosis
Piccoli, Leonora De Zorzi;Mattos, Angelo Alves de;Coral, Gabriela Perdomo;Mattos, ?ngelo Zambam de;Santos, Diogo Edele dos;
Arquivos de Gastroenterologia , 2011, DOI: 10.1590/S0004-28032011000300005
Abstract: context: chronic hepatitis c as well as non-alcoholic fatty liver disease are recognized as the main cause of liver disease in western countries. it is common to see the concomitance of the diseases and the influence of steatosis in the sustained virological response of patients with hepatitis c virus. objective: assess the sustained virological response in chronic hepatitis c patients according to the presence of liver steatosis. methods: one hundred sixty patients with chronic hepatitis c were retrospectively evaluated. demographic data such as gender, age, body mass index, presence of diabetes mellitus and systemic arterial hypertension, virus genotype and use of pegylated interferon were analyzed, as was the staging of fibrosis and the presence of steatosis at histology. results: most patients were male (57.5%), with a mean age of 48 ± 9.7 years. the most frequent genotype observed was 3 (56.9%) and, in the histological evaluation, steatosis was observed in 65% of the patients (104/160). sustained virological response in patients with steatosis occurred in 38.5%, and in 32.1% in patients without steatosis (p = 0.54). when we analyzed possible factors associated with the presence of steatosis, only body mass index and systemic arterial hypertension revealed a significant association. when the factors that influenced sustained virological response were evaluated in a logistic regression, genotype and use of pegylated interferon proved to be independent factors associated to the response. conclusion: in the evaluated patients the presence of liver steatosis did not influence the sustained virological response of patients with chronic hepatitis c treated with interferon and ribavirin.
Current perspectives on the efficacy and mechanisms of combination therapy for chronic hepatitis B virus
ZHANG Xinxin
Journal of Clinical Hepatology , 2013,
Abstract: The antiviral therapy is a main method to control chronic hepatitis B and prevent cirrhosis and hepatocarcinoma. However,the efficacy of current antiviral drugs are unsatisfactory. In order to optimize the antiviral strategy, it is worthy to investigate an important choice to combine antiviral drugs of different antiviral mechanism or different antiviral drug resistances. Although some relative studies and evidences have been taken, there are still many problems and arguments about combination therapy, which needs deep understanding of the pathogenesis and mechanism of poor antiviral response.
Therapeutic effect of antiviral therapy in chronic hepatitis B patients with nonalcoholic fatty liver disease
YING Ruosu
Journal of Clinical Hepatology , 2013,
Abstract: ObjectiveTo retrospectively analyze the therapeutic effect of antiviral therapy in the chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD) and to investigate whether hepatocyte steatosis affects the response to antiviral therapy in CHB patients. MethodsA total of 110 CHB patients and 99 CHB patients with NAFLD were enrolled in the study. Serum HBV DNA levels were measured by fluorescence quantitative PCR; serum HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb were quantified by chemiluminescence; biochemical indices were determined by automatic biochemical analyzer to evaluate the liver function. Results(1) When receiving antiviral therapy with interferon, the CHB patients had a significantly higher rate of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) normalization after 24 weeks of treatment (χ2=4.069, P=0.044) and a significantly higher rate of HBV DNA clearance after 48 weeks of treatment (χ2=17.327, P=0.000), as compared with the CHB patients with NAFLD; in all HBeAg-positive patients, those with only CHB had a significantly higher rate of ALT/AST normalization after 24 weeks of treatment (P<0.05) and significantly higher rates of HBV DNA clearance and HBeAg clearance after 24 and 48 weeks of treatment (P<0.05), as compared with those with CHB and NAFLD, but there was no significant difference in the rate of ALT/AST normalization between them after 48 weeks of treatment (P>0.05). (2) When receiving antiviral therapy with nucleos(t)ide analogues, the CHB patients had a significantly higher rate of ALT/AST normalization than the CHB patients with NAFLD after 48 weeks of treatment (χ2=7.620, P=0.006), but there was no significant difference in the rate of HBV DNA clearance between them after 24 and 48 weeks of treatment (P>0.05); in all HBeAg-positive patients, those with CHB and NAFLD had a significantly higher rate of HBeAg clearance after 24 weeks of treatment (P<0.05) and a significantly lower rate of ALT/AST normalization after 48 weeks of treatment (P<0.05), as compared with those with only CHB, but there were no significant differences in the rate of ALT/AST normalization after 24 weeks of treatment, rates of HBV DNA clearance after 24 and 48 weeks of treatment, and rate of HBeAg clearance after 48 weeks of treatment between them (P>0.05). ConclusionTo some extent, hepatocyte steatosis affects the response to antiviral therapy in CHB patients.
FATE OF PATIENTS WITH LATE-DETECTED HEPATITIS C INFECTION - CASE REPORTS
Velimir Kosti?,Aleksandar Petrovi?,Jelena Radovi?,Jovana Kosti?
Acta Medica Medianae , 2011,
Abstract: Chronic hepatitis C virus infection represents an insidious disease that is often detected with signs of liver cirrhosis or hepatocellular carcinoma. It is practicaly impossible to achieve a significant therapeutic progress in these patients without performing a liver transplantation. However, due to underdeveloped program of organ donations, this kind of intervention, as the last helpful procedure, is often not realized.This study presents three patients (out of 121 treated patients) followed during a two-year period. The patients had been initially registered when the stage of their disease became severe: liver failure with signs of decompensation. Antiviral therapy (pegylated interferon and ribavirin) in these patients have no use, hence only a corrective therapy is administered. Pathohistological findings in two patients revealed hepatocellular carcinoma, and in one case lethal outcome was the result of severe hepatic decompensation, hepatopulmonary and hepatorenal syndromes, as well as developed cardiopulmonary failure. Lethal outcome occurred in the period of 2 to 14 months after the first visit to a doctor. One patient was on the list for liver transplantation; however, surgery was not performed and soon after a fatal outcome ensued.
Evaluation of adherence to oral antiviral hepatitis B treatment using structured questionnaires
Leesa Giang,Christian P Selinger,Alice Unah Lee
World Journal of Hepatology , 2012, DOI: 10.4254/wjh.v4.i2.43
Abstract: AIM: To assess adherence rates to nucleos(t)ide analogues (NUCs) therapy in patients with chronic hepatitis B virus infection and determine factors associated with adherence. METHODS: The questionnaire study was conducted in the liver clinics at Concord Repatriation General Hospital. All patients who were currently taking one or more NUCs were asked to complete a structured, self-administered 32-item questionnaire. Adherence was measured using visual analogue scales. The patient’s treating clinician was also asked to assess their patient’s adherence via a structured questionnaire. RESULTS: A total of 80 patients completed the questionnaire. Sixty six percent of the patients (n = 49) reported optimal adherence whilst 25 (33.8%) graded their adherence to NUCs as suboptimal. Thirty four (43%) patients reported to have omitted taking their NUCs sometime in the past. Recent non-adherence was uncommon. Amongst the patients who reported skipping medications, the most common reason cited was ”forgetfulness“ (n = 27, 56.25%). Other common reasons included: ran out of medications (n = 5, 10.42%), being too busy (n = 4, 8.33%) and due to a change in daily routine (n = 5, 10.42%). Patients who reported low adherence to other prescription pills were also more likely to miss taking NUCs (P = 0.04). Patients who were under the care of a language-discordant clinician were also more likely to report suboptimal adherence to NUCs (P = 0.04). CONCLUSION: Adherence rates were much less than that expected by the physician and has potential adverse affect on long term outcome. Communication and education appear central and strategies need to be implemented to improve ongoing adherence.
Genetic diversity of NS3 protease from Brazilian HCV isolates and possible implications for therapy with direct-acting antiviral drugs
Peres-da-Silva, Allan;Almeida, Adilson José de;Lampe, Elisabeth;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000200016
Abstract: the hepatitis c virus (hcv) ns3 protease has been one of the molecular targets of new therapeutic approaches. its genomic sequence variability in brazilian hcv isolates is poorly documented. to obtain more information on the magnitude of its genetic diversity, 114 brazilian hcv samples were sequenced and analysed together with global reference sequences. genetic distance (d) analyses revealed that subtype 1b had a higher degree of heterogeneity (d = 0.098) than subtypes 1a (d = 0.060) and 3a (d = 0.062). brazilian isolates of subtype 1b were distributed in the phylogenetic tree among sequences from other countries, whereas most subtype 1a and 3a sequences clustered into a single branch. additional characterisation of subtype 1a in clades 1 and 2 revealed that all but two brazilian subtype 1a sequences formed a distinct and strongly supported (approximate likelihood-ratio test = 93) group of sequences inside clade 1. moreover, this subcluster inside clade 1 presented an unusual phenotypic characteristic in relation to the presence of resistance mutations for macrocyclic inhibitors. in particular, the mutation q80k was found in the majority of clade 1 sequences, but not in the brazilian isolates. these data demonstrate that brazilian hcv subtypes display a distinct pattern of genetic diversity and reinforce the importance of sequence information in future therapeutic approaches.
Replication of clinical hepatitis B virus isolate and its application for selecting antiviral agents for chronic hepatitis B patients
Yin-Ping Lu, Tao Guo, Bao-Ju Wang, Ji-Hua Dong, Jian-Fang Zhu, Zhao Liu, Meng-Ji Lu, Dong-Liang Yang
World Journal of Gastroenterology , 2008,
Abstract: AIM: To establish a cell model harboring replicative clinical hepatitis B virus (HBV) isolates and evaluate its application in individualized selection of anti-HBV agents for chronic hepatitis B (CHB) patients.METHODS: The full-length HBV genomic DNA from 8 CHB patients was amplified by polymerase chain reaction (PCR). All the patients were treated with lamivudine for at least seven months and finally became resistant to lamivudine. The amplified HBV DNA fragments were inserted into pHY106 vectors by Sap I digestion. The recombinant plasmids containing 1.1 copies of HBV genome were transiently transfected into Huh7 cell line, and the levels of HBsAg, HBeAg and intercellular HBV replicative intermediates were determined by ELISA and Southern blot analysis, respectively, with or without lamivudine and adefovir treatment. The antiviral treatment with adefovir was administered to the patients and analyzed in parallel.RESULTS: A total of 25 independent HBV isolates were obtained from the sera of 8 patients, each patient had at least two isolates. One isolate from each individual was selected and subcloned into pHY106 vector, including 5 isolates with YVDD mutation and 3 isolates with YIDD mutation. All recombinant plasmids harboring HBV isolates were transfected into Huh7 cells. The results indicated that HBV genome carried in HBV replicons of clinical HBV isolates could effectively replicate and express in Huh7 cells. Adefovir, but not lamivudine, inhibited HBV replication both in vitro and in vivo, and in vitro inhibition was dose-dependent.CONCLUSION: The novel method described herein enables individualized selection of anti-HBV agents in clinic and is useful in future studies of antiviral therapy for CHB.
Side effects of antiviral therapy in patients with chronic hepatitis C infection
Kosti? Velimir,Jovanovi? Maja,Radovi? Jelena,Vuji? Stevan
Medicinski Pregled , 2012, DOI: 10.2298/mpns1204106k
Abstract: Introduction. Chronic hepatitis C currently represents a global health problem, which is expected to be reduced by pegylated-interferon and ribavirin therapy. Material and Methods. We examined 88 patients with chronic hepatitis C, divided into three groups according to their comorbidity: the patients without comorbidity were in group I, group II included the patients on dialysis, and group III included the patients with hemophilia. Results. A significant difference was found in the percentage of achieved sustained virological response between the patients on dialysis and other patients, p<0.05. Having analyzed the therapy adverse effects, we observed a significantly higher decrease of erythrocytes count, hemoglobin and hematocrit levels in dialysis patients compared to others (p<0.01). The patients on hemodialysis predominantly had anemia and leukopenia, while thrombocytopenia was equally present in all groups. The dominant clinical side effect was flu-like syndrome, present in more than a half of patients. Discussion. The therapy positive effect is usually accompanied with adverse effects. The lowest therapeutic response was recorded in group II, due to the virus genotype 1. A significant decrease in hematological parameters was determined in all patients. The most common clinical adverse effect was flu-like syndrome, later manifestations included: weight loss, alopecia, insomnia and irritability. Side effects like psychosis, thyroid gland dysfunction or psoriasis were not recorded. Conclusion. A significant decrease in the value of all these hematological parameters was found in all groups of patients. Clinical side effects were present in 60% of patients. Side effects did not lead to discontinuation of therapy, but only to modification of drug doses.
Suggested guidelines for the diagnosis and management of chronic HCV infection in children  [PDF]
Fazal-i-Akbar Danish
Open Journal of Gastroenterology (OJGas) , 2012, DOI: 10.4236/ojgas.2012.23027
Abstract: HCV infection in children is different from the adult infection in many ways like natural course of the disease; duration, therapeutic response and side effects profile of the drug therapy; and prognosis. Special considerations include what is the appropriate time to investigate a suspected child, when to institute and choice of drug therapy and how to prevent vertical transmission. In this article, based on the current evidence suggested guidelines for the diagnosis and management of chronic HCV infection in children is given. Feedback to help improve/modify these recommendations by those experienced in dealing with the children will be welcome.
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