RESUMO
Extremely low levels of serum hepatitis C virus (HCV) RNA can be detected by COBAS TaqMan HCV test. To investigate whether the COBAS TaqMan HCV test is useful for measuring rapid virological response (RVR) and early virological response (EVR) to predict sustained virological response (SVR), we compared the virological response to PEG-IFN-alfa 2a plus RBV in 76 patients infected with HCV genotype 1 when undetectable HCV RNA by the COBAS TaqMan HCV test was used, with those when below 1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test was used, which corresponded to the use of traditional methods. Among the 76 patients, 28 (36.8%) had SVR, 13 (17.1%) relapsed, 19 (25.0%) did not respond, and 16 (21.0%) discontinued the treatment due to side effects. The positive predictive values for SVR based on undetectable HCV RNA by COBAS TaqMan HCV test at 24 weeks after the end of treatment [10/10 (100%) at week 4, 21/23 (91.3%) at week 8 and 26/33 (78.7%) at week 12] were superior to those based on <1.7 log IU/mL HCV RNA [17/19 (89.4%) at week 4, 27/38 (71.0%) at week 8, and 27/43 (62.7%) at week 12]. The negative predictive values for SVR based on <1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test [46/57 (80.7%) at week 4, 37/38 (97.3%) at week 8, and 32/33 (96.9%) at week 12] were superior to those based on undetectable HCV RNA [48/66 (72.7%) at week 4, 46/53 (86.7%) at week 8, and 41/43 (95.3%) at week 12]. The utilization of both undetectable RNA and <1.7 log IU/mL HCV RNA by COBAS TaqMan HCV test is useful and could predict SVR and non-SVR patients with greater accuracy.
Assuntos
Antivirais/uso terapêutico , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Polietilenoglicóis/uso terapêutico , Ribavirina/uso terapêutico , Adulto , Idoso , Quimioterapia Combinada , Feminino , Genótipo , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/genética , Humanos , Interferon-alfa/administração & dosagem , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/administração & dosagem , Prognóstico , RNA Mensageiro/sangue , RNA Viral/sangue , RNA Viral/genética , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêutico , Ribavirina/administração & dosagem , Resultado do TratamentoRESUMO
We have experienced epithelial dysplasia and invasive carcinoma of oral cavity, showing punctation and mosaic like atypical vessels confirmed by usual photographing. Case 1: 42-year-old man. After resection of tongue leukoplakia, the punctation appeared in the distal region of resected wound. Pathological findings were epithelial dysplasia, and expansion of capillaries in the stromal papillae were close to the surface. Case 2: 55-year-old woman. Punctation and mosaic like atypical vessels were recognized in the buccal mucosa, extending from the gingival carcinoma. Pathological findings were epithelial dysplasia and carcinoma in situ in punctation, and early invasive carcinoma in mosaic. There were irregularly expanded capillaries in the stromal papillae being close to the surface at both mosaic and punctation area. Although punctation, atypical vessels and mosaic are the colposcopic findings of uterine cervical cancer, these findings may become diagnostic point of early oral cancer.