Efficacy of Direct Acting Antivirals (DAA) therapy in patients with recurrent hepatitis C after liver and kidney transplantation: a cross-sectional study.

Background and objectives: Direct-acting antiviral (DAA) agents are now widely used to treat patients with hepatitis C infection (HCV) and effectively increase their sustained virologic response (SVR). However, the literature seems to lack or deficient evidence of DAA efficacy in more complicated patients, especially those with HCV reinfection after liver transplantation (LT) or liver-kidney (hepatorenal) transplantation (LKT). This study aimed to retrospectively evaluate the effectiveness of two different DAA regimens in LT and LKT patients with HCV reinfection. Methods: This cross-sectional study was conducted at three hospitals in Tehran, Iran, from 2014 to 2020, enrolling 53 patients with recurrent HCV infection after LT (n = 35) or LKT (n = 18). Patients were treated for 12 weeks with one of two DAA regimens: 37 patients (70%) received Daclatasvir and Sofosbuvir (SOF + DCV), while 16 patients (30%) received Sofosbuvir and Ledipasvir (SOF + LDV). Ribavirin (RBV) was added as an adjunct antiviral in 28 patients (52.8%). To assess the SVR, all patients were followed for 12 weeks after treatment. Results: Both DAA regimens were well-tolerated and effective, with 94.6% (35 of 37) achieving SVR-12 in the SOF + DCV group and 93.8% (15 of 16) in the SOF + LDV group. Additionally, SVR-12 rates were promising across treatment durations, with 93.9% (31 of 33) in the 12-week group and 95% (19 of 20) in the 24-week group achieving undetectable HCV RNA. No significant difference in SVR was observed between the two regimens (p = 0.439). Conclusion: The DAA-based therapeutic regimen was well tolerated and showed significant effectiveness in achieving the virologic response in patients with HCV reinfection after LT or LKT.

Correlation Between Serum Homocysteine Levels and Carotid Intima-media Thickening in Hemodialysis Patients.

NTRODUCTION: Hyperhomocysteinemia is an important risk factor for cardiovascular disease in ESKD patients. Homocysteine, as an inflammatory factor, and carotid intima-media thickness (CIMT) could predict atherosclerosis in hemodialysis-treated ESKD patients. In this regard, the present study was conducted to investigate serum homocysteine level and its relationship with internal carotid intima thickness in ESKD patients undergoing routine hemodialysis. METHODS: This study comprised 56 ESKD patients, older than 40 years, undergoing hemodialysis for at least 1 year. All participants were taking Nephrovit for at least 6 months. The study participants were patients who underwent ultrasonography for CIMT determination and laboratory test Results. There was no statistically significant relationship between the mean homocysteine level and hypertension, diabetes mellitus, duration of dialysis, and body mass index (BMI). Among the study participants, the results also showed that the mean value of CMIT homocysteine and C-reactive protein (CRP) were 0.89 millimeters, 30.44 (mcmol/L), and 35.60 mg/L; respectively. Despite hypertension, there was a significant difference between the mean values of CMIT in patients with diabetes mellitus and those who had been on dialysis for a longer period (more than 3 years). Also, the mean value of CMIT was significantly higher in obese patients than those with normal BMI. None of the other variables including homocysteine serum level, C-reactive protein (CRP), and CMIT showed a significant correlation. CONCLUSION: The results of the study suggest that there is no relationship between serum homocysteine level and carotid intima-media thickness in hemodialysis patients.  DOI: 10.52547/ijkd.7424.

Early amiodarone pneumonitis: A case report.

Consider amiodarone pneumonitis as an important differential diagnosis of ARDS, especially in clinically ill patients who recently received Intravenous amiodarone.