[Efficacy and safety of boceprevir based triple therapy in Hungarian patients with hepatitis C genotype 1 infection, advanced stage fibrosis and prior treatment failure]. / Bocepreviralapú hármas kezelés hatékonyságának és biztonságosságának retrospektív elemzése elorehaladott fibrosisstádiumú, hepatitis C-vírus 1-es genotípussal fertozött, korábban sikertelenül kezelt magyar betegeknél.

INTRODUCTION: During 2011 and 2013, 155 Hungarian hepatitis C genotype 1 infected patients, mostly with advanced liver fibrosis, who did not respond to prior peginterferon + ribavirin dual therapy, started boceprevir based triple therapy in an early access program. AIM AND METHOD: Efficacy and safety of the therapy was retrospectively assessed based on sustained virologic responses, as well as on frequency and type of serious adverse events and of those leading to therapy discontinuation. RESULTS: In an intent-to-treat analysis 39.4% patients (61/155) reached sustained virologic response. Amongst pervious relapsers, partial responders and null-responders 59.5%, 41.4 % and 22.9% (p<0.05 compared to the other two categories) reached sustained virologic response, respectively, while amongst non-cirrhotics and cirrhotics 52.5% and 31.3% (p<0.05 compared to the non-cirrhotics) achieved sutained virologic response, respectively. Six out of the 33 most difficult to cure patients (previous null responder and cirrhotic) have reached sustained virologic response (18.2%). Frequency of early discontinuations due to insufficient virologic response was 31.1%, while due to adverse event 10.3%. Reported frequency of serious adverse event was 9.8%. These events represented anemia, diarrhoea, depression, agranulocytosis, elevated aminotransferases, generalized dermatitis and severe gingivitis with loss of teeth, prolonged QT interval on ECG, generalized oedema and severe dyspnoea, uroinfection, exacerbation of Crohn's disease, Campylobacter pylori infection and unacceptable weakness and fatigue. Eight patients received transfusion, 4 patients erythropoietin and 1 granulocyte colony stimulating factor during therapy. No death has been reported. CONCLUSIONS: With boceprevir based triple therapy, one of the bests available in 2011-2013 in Hungary, a relevant proportion of hepatitis C infected patients with advanced liver fibrosis achieved sustained viral response. In this cohort, side-effects resembled those reported in registration studies, and resulted in therapy discontinuation with consequent treatment failure in a relevant number of patients. Efficacy and tolerability of boceprevir-based triple therapy are suboptimal, particularly in the most difficult to cure patient population. Orv. Hetil., 2016, 157(34), 1366-1374.

[Seroprevalence of Helicobacter pylori infection and anti-CagA positivity in the county Szabolcs-Szatmár-Bereg]. / Helicobacter pylori szeroprevalencia és anti-CagA pozitivitás Szabolcs-Szatmár-Bereg megyében.

The authors studied the seroprevalence of Helicobacter pylori infection and the risk factors for infection, among adult volunteers from Szabolcs-Szatmár-Bereg county, East Hungary in year 2000. Sera were collected from 756 adults (328 males, 428 females, m/f = 1.5:2; mean age 42.4 yrs.; range 18-69 yrs.). Anti-Helicobacter pylori IgG and anti-CagA IgG antibodies were identified serologically using a sensitive ELISA technique. A questionnaire was completed to obtain necessary informations. The overall rate of seropositivity was 58.6% (45.2% in those aged 18-29 and 69.6% in those aged 50-59). Seropositivity was significantly higher in rural population than in urban area (p < 0.001), sharing a bed (p < 0.001), if parents were manual workers (p < 0.001), between keepers of cat (p < 0.005). The authors found a significant inverse correlation between Helicobacter pylori infection and educational level (p < 0.001), income (p < 0.005), absence of water supply and sanitation (childhood: p < 0.001, adulthood: p < 0.05). There were no significant differences in Helicobacter pylori infection related to gender, subject's occupation, smoking and drinking habits, gastric symptoms, family history of ulcer or gastric cancer. 67.5% of Helicobacter pylori positives were anti-CagA positives too. Helicobacter pylori positivity is higher than in developed countries, and than in the more developed county Vas.