Role of IL28B gene polymorphism and cell-mediated immunity in spontaneous resolution of acute hepatitis C.

BACKGROUND: A single-nucleotide polymorphism (SNP; rs12979860) near the IL28B gene has been associated with spontaneous and treatment-induced hepatitis C virus clearance. We investigated predictors of spontaneous disease resolution in a cohort of patients with acute hepatitis C (AHC), analyzing epidemiological, clinical and virological parameters together with IL28B.rs12979860 genotypes and cell-mediated immunity (CMI). METHODS: Fifty-six symptomatic AHC patients were enrolled and followed prospectively. CMI was measured in 31 patients at multiple time points by interferon-γ enzyme-linked immunospot assay and was correlated to the IL28B.rs12979860 SNP. RESULTS: Eighteen patients had a self-limiting AHC that was associated with female sex (P = .028), older age (P = .018), alanine aminotransferase level >1000 U/L (P = .027), total bilirubin level >7 mg/dL (P = .036), and IL28B.rs12979860 genotype CC (P = .030). In multivariate analysis, only CC genotype was independently associated with self-limiting AHC (odds ratio, 5.3; 95% confidence interval, 1.1-26.5). Patients with the CC genotype with self-limiting AHC had a stronger (P = .02) and broader (P = .013) CMI than patients with the CT genotype with chronically evolving AHC. In patients with chronically evolving disease, CC genotype was associated with a broader CMI compared to CT genotype (P = .028). A negative CMI was more frequently associated with CT genotype among persistently infected patients (P = .043) and with persistent infection among CT patients (P = .033). CONCLUSIONS: . Self-limiting AHC was independently associated with CC genotype. The correlation between IL28B.rs12979860 genotypes and CMI is suggestive of a possible important role of CMI in favoring hepatitis C virus clearance in CC patients.

[Peritoneal dissemination of hepatic hydatidosis: a case report]. / Disseminazione peritoneale di idatidosi cistica epatica: descrizione di un caso.

We describe an unusual case of disseminated peritoneal hydatidosis in a 64 year ld woman, with previous surgery for liver hydatidosis (22 years before) and show the radiological features in question. Serological tests and radiological imaging allow diagnosis of hydatid disease and are useful in assessing response to therapy. In this case no changes in size, number and density of lesions and clinical features are present after albendazole therapy.

[Incidence of extended spectrum beta-lactamase (ESBL)-producing Enterobacteria in the area of Caltagirone (Sicily)]. / Frequenza di Enterobatteri produttori di beta-lattamasi a spettro esteso (ESBL) nell'area di Caltagirone (Sicilia).

The authors report the incidence of extended spectrum b-lactamases (ESBL)- producing strains in 1,602 enterobacteria consecutively isolated, from April 2002 to December 2003, in Caltagirone (CT) Hospital, and their in vitro susceptibility to several antimicrobial agents. The incidence of ESBL-producing Enterobacteria was equal to 1.5%, mainly among Escherichia coli, Klebsiella spp and Citrobacter koseri, isolated by emergency and medicine wards. In vitro, the enterobacteria were fully susceptible to carbapenems and highly susceptible to third-generation cephalosporin, aztreonam, piperacillin, amikacin, and ciprofloxacin.

[Pulmonary complications from pandemic AH1N1 influenza: clinical-radiological features]. / Complicanze polmonari in corso di pandemia influenzale: aspetti clinico-radiologici.

We describe the epidemiology, clinical features, radiological findings, therapy and course for 15 patients hospitalized at the Infectious Diseases UOC of Gravina Hospital Caltagirone for a serious respiratory condition with verified infection A (H1N1) from 9 November to 22 December 2009. We retrospectively reviewed medical records, laboratory and instrumental tests performed on hospitalized patients. All patients had significant respiratory impairment: nine had co-morbidities and risk factors such as obesity, pregnancy, immunosuppressant conditions and muscular dystrophy. Symptoms were similar to those of seasonal influenza; radiological investigation of the chest (RX and CT) presents lung involvement in 80% of patients and changes in the bio-humoral indices. Development into acute respiratory distress syndrome (ARDS) was observed in six patients: three were ventilated with a Venturi mask, three were treated in intensive care and two patients used extracorporeal membrane oxygenation (ECMO). Two died. All patients received antiviral and symptomatic therapy for 5-21 days. A(H1N1) virus infection led to a mild to moderate flu syndrome, which was often cured by symptomatic treatment; some patients required hospitalization for viral pneumonia, mixed pneumonia or ARDS. In previous flu epidemics there was no development into ARDS (40% in our series).