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European Heart Journal 03/2009; 30(8):1014. · 10.48 Impact Factor
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Transplant International 10/2007; 20(9):808-10. · 2.92 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the efficacy of interferon alpha (IFNalpha)-2b in combination with oral ribavirin for treatment of chronic hepatitis C in relation to age, sex, liver enzymes activity as well as to grading and staging of liver disease in histologic examination. There were 154 adult patients assigned for the retrospective analysis including 69 females and 85 males of 16 to 70 years of age (mean age 43.3 +/- 12 years) treated with IFNalpha and ribavirin for 24 or 48 weeks. Sustained virological response was achieved in 66 patients (42.9%) and sustained biochemical response rate was 44%. Sustained response correlated with younger age, lower baseline AST, GT and ALP activities as well as with lower staging of liver disease. Combination treatment with interferon and ribavirin was significantly more effective in patient under 40 years of age and in patients without cirrhosis. Sex, baseline ALT activity and histological grading of liver disease did not differ between sustained responders and non-responders. Sustained virological response on combination therapy was achieved in 5 out of 7 previous monotherapy relapsers (71.4%) whereas only 5 patients out of 22 monotherapy non-responders benefited from combination therapy (22.7%). In conclusion, efficacy of combination therapy with IFNalpha and ribavirin in patients with liver cirrhosis is less effective and should be considered in chosen situations, especially in younger patients. Normal ALT activity should not be an exclusion criterion to therapy. Combination retherapy in previous monotherapy non-responders seems to be ineffective whereas in monotherapy relapsers good sustained response can be achieved.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2005; 58(11-12):616-21.
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Jacek Juszczyk,
Barbara Baka-Cwierz,
Marek Beniowski,
Hanna Berak,
Beata Bolewska,
Anna Boroń-Kaczmarska,
Janusz Cianciara,
Andrzej Cieśla,
Andrzej Dziambor,
Jacek Gasiorowski, [......],
Magdalena Sliwińska,
Katarzyna Swietek,
Krzysztof Tomasiewicz,
Ewa Topczewska-Staubach,
Hanna Trocha,
Marek Wasilewski,
Marta Wawrzynowicz-Syczewska,
Witold Wrodycki,
Dorota Zarebska-Michaluk,
Małgorzata Zejc-Bajsarowicz
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ABSTRACT: We evaluated the efficacy and safety of peginterferon alfa-2a [40KD] (Peg-IFNalpha-2a) plus ribavirin in patients with chronic hepatitis C in an open-label programme in a routine clinical setting in Poland. Patients received Peg-IFNalpha-2a 180mg/week plus ribavirin 800-1200 mg/d for 48 weeks. Sustained virological response (SVR) was defined as undetectable HCV RNA (<50IU/mL) at the end of follow-up (week 72). 466 adults were enrolled. Most patients (87.3%) had genotype 1 infection. 440 subjects (94,4%) completed treatment. The overall SVR rate was 55.7%. A higher SVR rate was obtained in treatment-naïve patients (58.7%) than in relapsers (47.8%; p=0,048). SVR rates in genotype 1 and non-1 patients were 51.1% and 88.5%, respectively (p<0.001). There were significant higher SVR rates in patients with lower baseline fibrosis (p=0,01). There were no differences in SVRs by gender or viral load. Hemoglobin, leukocyte and neutrophil levels decreased significantly during treatment, but returned to baseline after the end of treatment. ALT levels decreased significantly during treatment in patients with and without an SVR. 38.4% of patients experienced adverse events like neutropenia, anemia, thrombocytopenia, and other. There was one death (severe thrombocytopenia). CONCLUSIONS: The overall SVR achieved in this predominantly genotype 1 population was 55.7%. SVR rates were significantly higher in treatment-naïve patients, those with non-1 genotypes, and in patients with lower baseline fibrosis scores.
Przegla̧d epidemiologiczny 01/2005; 59(3):651-60.
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Jacek Juszczyk,
Jolanta Białkowska,
Beata Bolewska,
Anna Boroń-Kaczmarska,
Andrzej Gładysz,
Waldemar Halota,
Małgorzata Inglot,
Urszula Janas-Skulina,
Maciej Jabłkowski,
Joanna Jabłonska, [......],
Paweł Pabjan,
Małgorzata Pawłowska,
Paweł Piszko,
Katarzyna Sikorska,
Katarzyna Swiqtek,
Krzysztof Tomasiewicz,
Ewa Topczewska-Staubach,
Marta Wawrzynowicz-Syczewska,
Dorota Zarqbska-Michaluk,
Małgorzata Zejc-Bajsarowicz
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ABSTRACT: 150 adult patients were assigned pegylated interferon alpha-2b (once weekly 1.5 microg/kg) plus ribavirin (800-1200 mg depending on bodyweight). The treatment lasted 52 weeks and was completed by 139 persons (92.7%). Because of adverse events the treatment was interrupted in 7 persons, 4 other persons resigned. Periodical reduction of pegylated interferon doses was necessary in 19% and the reduction of ribavirin in 21% of patients. Six months after the completion of treatment HCV-RNA was negative in 82 (59%) patients. Neither hepatitis C virus genotype, nor viremia was marked in the study. The negative correlation between the degree of fibrosis in the liver tissue and the results of sustained virological response was stated. Degree of inflammation at liver tissue, sex, age over and less than 40 years did not correlate with the final virological results. The recurrence of infection happened at 7% of the treated persons (negative HCV-RNA directly after the treatment--positive 6 months after the completion). During the treatment period, and comparison with the results obtained before its implementation, statistically significantly decreased: hemoglobin concentration, the number of leukocytes, granulocytes and thrombocytes. They returned to the referential values half a year after the completion of treatment. The activity of enzymes (AIAT, AspAT, GGTP) was decreasing statistically significantly since the first weeks of the treatment till the end and remained significantly lower after 6 months. In both sexes statistically significant reduction of bodyweight was stated, while it increased during the six months after the completion of treatment. Adverse events, which mostly were mild and were not the cause of interruption of treatment, were numerous and occurred at different frequency, in the range from over 50% (flu-like) to 0.7%.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 05/2004; 16(94):353-7.
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ABSTRACT: The activity of alanine aminotransferase (ALT) is the most popular parameter in hepatology. Increase of ALT usually suggests the damage of hepatocytes. The aim of the study was to assess the range of value of serum alanine aminotransferase in healthy population and to assess the relationship between ALT level and body mass index (BMI), age and gender. We have analyzed a large population of healthy blood donors--all of them were screened for ALT, weight and height. Patients were divided into four groups: I--patients with underweight, II--patients with normal weight, III--patients with overweight, IV--obese patients. In the studied population 862 persons were taken into account (820 men and 42 women), 19-62 years of age. The ALT level varied from 6 to 77 U/L, mean 27.39 U/L. Inadequate BMI was found in 12 persons, normal BMI in 497 persons, overweight in 270 persons and obesity in 83 persons. ALT and BMI are statistically significantly higher in men than in women. In general population and in men group we found correlations between ALT and BMI (p = 0.0000), between ALT and age (p = 0.0000). In women we did not find those dependences. ALT level was statistically significantly higher in groups with higher BMI: ALT level in group II was higher than in group I (p < 0.024), ALT level in group III was higher than in group III (p = 0.0000). We did not find any differences in ALT level between group III and IV. ALT level strongly correlates with body mass, age and gender. We suggest the necessity of taking into consideration those parameters in a clinical interpretation of ALT level.
Wiadomości lekarskie (Warsaw, Poland: 1960) 01/2004; 57(9-10):427-30.
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ABSTRACT: Increased incidence of hepatocellular carcinoma related to hepatitis C virus (HCV) infection has been noted recently. Only in year 2000 seven new cases of HCC in HCV-positive patients were diagnosed. In all cases liver tumors were found in cirrhotic patients and they were at advanced stage (multiple or large in size) precluding successful therapy. More than half of HCC cases related to HCV infection were connected with blood transfusion(s) in the past. Patients transfused a few decades ago should be screened for HCV infection and those with liver cirrhosis require careful and regular monitoring including ultrasound and a-fetoprotein examinations in order to detect focal lesions at less advanced stage making medical intervention possible.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 09/2002; 13(74):100-2.
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ABSTRACT: Comparison of the iron status in patients who responded and did not respond to combination treatment with interferon alpha and ribavirin in chronic hepatitis C.
The study group comprised of 61 patients with chronic hepatitis C (genotype 1) treated with alpha 2b interferon and ribavirin. The iron metabolism was evaluated based on serum iron level, total iron binding capacity, transferrin saturation, serum ferritin concentration and hepatic iron concentration. In the evaluation of antiviral treatment efficacy biochemical and virological responses were taken into account.
End of treatment response was observed in 38 patients (62%). Significant differences in iron parameters were not observed between responders and non-responders. Also, sustained viral response, 6 months after treatment completion, was reached in 32 patients (52.5%). Iron metabolism parameters did not differ significantly in the group of sustained responders versus non- responders. Finally, ALT normalization was observed in 42 patients (68.9%). Again, no significant differences in iron status were observed between patients with and without biochemical response excluding significantly higher serum ferritin concentration in non-responders.
Results of this study show that iron status does not significantly influence the efficacy of treatment with interferon and ribavirin in patients with chronic hepatitis C.
Hepato-gastroenterology 55(82-83):557-61. · 0.66 Impact Factor
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ABSTRACT: We aimed to study the relationship between HBcAg in liver tissue, histological and biochemical activity and serum HBV-DNA levels among HBeAg-negative patients.
49 biopsy specimens taken from 16 females and 29 males were studied. Immunostaining for HBcAg was performed with commercially available kits (Dako). Serum HBV-DNA was detected by the hybridization method, in case of negative hybridization, repeated by PCR.
HBcAg was found in 16 biopsy specimens (32.6%) (group I)--in 10 cases in hepatocytes nuclei and cytoplasm, in 5 in the nuclei and in one case in cytoplasm only. 15 out of 16 patients were serum HBV-DNA positive. Seven patients showed chronic liver disease of moderate or severe activity with HBcAg expression both in the nuclei and cytoplasm. Group II consisted of 33 patients who were HBcAg-negative. In 7 patients HBV-DNA was not found by hybridization or by PCR. In eleven patients ALT and AST activity exceeded 1.5x the ULN. ALT and AST differed significantly between group II and I.
In our opinion immunohistochemical examination is an essential part of classification to antiviral treatment. HBcAg immunostaining should be performed in every HBeAg-negative patient to exclude reasons for aminotransferase elevation other than HBV infection.
Hepato-gastroenterology 51(57):709-12. · 0.66 Impact Factor
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ABSTRACT: Weight gain is commonly observed after OLTx. It is still debatable whether increasing weight is due to the regain of weight lost before transplantation or it is a complex metabolic disorder.
Body mass index and weight gain were sought at 6 months, one, two and four years after liver transplantation (OLTx) in relation to sex, weight at the time of transplantation, aetiology of liver disease, type of immunosuppression, glucose metabolism and lipid parameters as well as cardiovascular episodes. A group of 75 patients has been studied.
Mean weight gain and BMI change were the highest within the first six months after OLTx (6.1 kg and 2.0 kg/m(2), respectively); since than gaining weight decreased. Men gained more weight than women, especially in the first half-year after OLTx. The only clear predictive factor of overweight and obesity was the baseline weight (the higher the baseline weight the most dynamic the weight gain after OLTx).
Dietary mistakes and lack of physical activity may play a major role in the weight increase after OLTx. Despite striking proportion of overweight and obese patients in the studied group, the number of cardiovascular episodes seem to match the general population.
Annals of transplantation: quarterly of the Polish Transplantation Society 14(3):45-50. · 2.02 Impact Factor
