RESUMO
BACKGROUND: Sustained virologic response (SVR) to treatment of naïve patients with chronic hepatitis C (HCV) with pegylated interferon and ribavirin is 50-60%. Patients who relapse have a poor response to re-treatment. We report a group of relapse patients with SVR to low-dose re-treatment after 6 months. AIM: Characterization of HCV relapse patients with very low viral load (VLVL) (HCV RNA <5,000 IU/ml) 6 months after stopping full-dose initial treatment. METHODS: We identified 120 consecutive naïve patients over 4 years treated with pegylated interferon alpha-2a and ribavirin with full-dose therapy for 24 weeks (non-genotype 1) or 48 weeks (genotype 1) with baseline liver biopsy and at least 6 months of follow-up after treatment. HCV RNA by PCR and hepatic blood tests were obtained monthly during treatment and at least 1, 3, and 6 months post treatment. RESULTS: Of the initially treated patients, 54.2% had SVR, 25% non-response and 20.8% relapsed. Four of 25 who relapsed (16%) and one similar patient referred to our program had HCV RNA <5,000 IU/ml 6 months after stopping treatment (VLVL relapse). Significant differences (P < 0.05) compared with the 21 other relapse patients included all five patients who were genotype 1; 4/5 had cirrhosis, baseline HCV RNA was lower, and all had SVR to less intensive re-treatment for 6 months. CONCLUSION: VLVL relapse patients should be sought, because SVR to re-treatment is common despite genotype 1 cirrhosis.
Assuntos
Antivirais/uso terapêutico , Hepacivirus/genética , Hepatite C Crônica/sangue , Hepatite C Crônica/tratamento farmacológico , RNA Viral/sangue , Carga Viral , Adulto , Estudos de Coortes , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Seguimentos , Genótipo , Humanos , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes/uso terapêutico , Recidiva , Estudos Retrospectivos , Ribavirina/uso terapêutico , Resultado do TratamentoAssuntos
Ácidos Nucleicos Livres/análise , Deleção Cromossômica , Cromossomos Humanos X , Diagnóstico Pré-Natal/métodos , Síndrome de Turner/diagnóstico , Adulto , Ácidos Nucleicos Livres/sangue , Aberrações Cromossômicas , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez/sangue , Síndrome de Turner/genéticaRESUMO
cfDNA sequencing for fetal aneuploidy may detect chromosomal abnormalities representative of maternal malignancy.Maternal malignancy must be considered when abnormal cfDNA sequencing for fetal aneuploidy is associated with normal fetal karyotype.
Assuntos
Antibacterianos/uso terapêutico , Modelos Animais de Doenças , Cirrose Hepática/tratamento farmacológico , Animais , Humanos , Cirrose Hepática/mortalidade , Falência Hepática Aguda/mortalidade , Falência Hepática Aguda/terapia , Testes de Função Hepática , Regeneração Hepática , Ensaios Clínicos Controlados Aleatórios como Assunto , Ratos , Resultado do TratamentoRESUMO
The delivery of copper to mammary gland and milk and the effects of lactation were examined in rats. Traces of (67)Cu/(64)Cu(II) were injected intraperitoneally or intravenously into virgin rats or lactating rats (2-5 days postpartum), and incorporation into blood, milk, and tissues was monitored. In virgin rats, most of the isotope first entered the liver and kidney. In lactating rats, almost 60% went directly to the mammary gland. Uptake rates and copper contents of the mammary gland were 20-fold higher in lactation. (67)Cu/(64)Cu appeared in milk and milk ceruloplasmin as rapidly as in mammary tissue and when there was no (67)Cu/(64)Cu-ceruloplasmin in the maternal plasma. Plasma (125)I-labeled albumin entered milk much more slowly. Milk ceruloplasmin (10 mg/l) had 25% of the (67)Cu/(64)Cu. Milk copper was 3.3 mg/l. Thus lactation markedly enhances the avidity of the mammary gland for copper, diverting most of it from liver and kidney to that tissue. Also, the primary source of milk ceruloplasmin is the mammary gland and not the maternal plasma.